{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "9191 W FLORISSANT AVE STE 200C",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAINT LOUIS",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63136-1413",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "314-240-4519",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "9191 W FLORISSANT AVE STE 200C",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAINT LOUIS",
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"PracticeLocationAddressTelephoneNumber": "314-240-4519",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/28/2022",
"LastUpdateDate": "04/28/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BROWN",
"AuthorizedOfficialFirstName": "ASHLEY",
"AuthorizedOfficialMiddleName": "MONIC",
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialCredential": "CNA",
"AuthorizedOfficialTelephoneNumber": "314-240-4519",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}