{
"Npi": {
"NPI": "1639310881",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GC HOME HOLDINGS, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4322 ALEXANDRIA PIKE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COLD SPRING",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "41076-1918",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "859-261-5231",
"MailingAddressFaxNumber": "859-261-1008",
"FirstLinePracticeLocationAddress": "401 E 20TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "COVINGTON",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "41014-1583",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "859-283-6600",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/18/2009",
"LastUpdateDate": "01/22/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HAGAN",
"AuthorizedOfficialFirstName": "GEORGE",
"AuthorizedOfficialMiddleName": "S",
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "IV",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "859-261-5231",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "100266",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}