{
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LIGHTHOUSE HOMECARE",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"OtherOrgName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3565 UTICA RIDGE RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BETTENDORF",
"MailingAddressStateName": "IA",
"MailingAddressPostalCode": "52722-1654",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "563-441-9982",
"MailingAddressFaxNumber": "563-424-1016",
"FirstLinePracticeLocationAddress": "3565 UTICA RIDGE RD",
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"PracticeLocationAddressCityName": "BETTENDORF",
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"PracticeLocationAddressTelephoneNumber": "563-441-9982",
"PracticeLocationAddressFaxNumber": "563-424-1016",
"EnumerationDate": "05/10/2016",
"LastUpdateDate": "05/10/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCNAB",
"AuthorizedOfficialFirstName": "SCOTT",
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"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "563-441-9982",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251J00000X",
"TaxonomyName": "Nursing Care Agency",
"LicenseNumber": "4000444",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "253Z00000X",
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}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}