{
"Npi": {
"NPI": "1598608382",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ELTON WELLNESS INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "30 W MAIN ST STE 202",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WATERBURY",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06702-2012",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "475-233-1929",
"MailingAddressFaxNumber": "475-233-1953",
"FirstLinePracticeLocationAddress": "30 W MAIN ST STE 202",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WATERBURY",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06702-2012",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "475-233-1929",
"PracticeLocationAddressFaxNumber": "475-233-1953",
"EnumerationDate": "04/14/2026",
"LastUpdateDate": "04/14/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RIZVI",
"AuthorizedOfficialFirstName": "FUZAIL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MANAGING MEMBER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "571-225-8735",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}