{
"Npi": {
"NPI": "1669482261",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CSRA HOME HEALTH AGENCY, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 189",
"SecondLineMailingAddress": "127 GORDON ST.",
"MailingAddressCityName": "WASHINGTON",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30673-0189",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "800-344-6371",
"MailingAddressFaxNumber": "706-678-3049",
"FirstLinePracticeLocationAddress": "127 GORDON ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WASHINGTON",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30673-1601",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "800-344-6371",
"PracticeLocationAddressFaxNumber": "706-678-3049",
"EnumerationDate": "08/08/2006",
"LastUpdateDate": "12/12/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BRADFORD",
"AuthorizedOfficialFirstName": "C.",
"AuthorizedOfficialMiddleName": "SCOTT",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "800-344-6371",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "157-040",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}