{
"Npi": {
"NPI": "1629354808",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EXECUTIVE HOME HEALTH, 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": "750 S RAYMOND AVE",
"SecondLineMailingAddress": "SUITE 123",
"MailingAddressCityName": "PASADENA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91109-3244",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "626-765-9202",
"MailingAddressFaxNumber": "626-765-9206",
"FirstLinePracticeLocationAddress": "750 S RAYMOND AVE",
"SecondLinePracticeLocationAddress": "SUITE 123",
"PracticeLocationAddressCityName": "PASADENA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91105-3244",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "626-765-9202",
"PracticeLocationAddressFaxNumber": "626-765-9206",
"EnumerationDate": "11/01/2011",
"LastUpdateDate": "04/03/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FRAIPONT",
"AuthorizedOfficialFirstName": "MICHAEL",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "626-765-9202",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}