{
"Npi": {
"NPI": "1619349800",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HEAL AT HOME HEALTHCARE LLC",
"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": "5955 RAND BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SARASOTA",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34238-5160",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "352-347-1111",
"MailingAddressFaxNumber": "352-415-3104",
"FirstLinePracticeLocationAddress": "3200 SW 34TH AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OCALA",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34474-7456",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "352-347-1111",
"PracticeLocationAddressFaxNumber": "352-415-3104",
"EnumerationDate": "10/27/2015",
"LastUpdateDate": "03/07/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOUHAMID",
"AuthorizedOfficialFirstName": "SAIDA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CFO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "941-552-7599",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "21496096",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}