{
"Npi": {
"NPI": "1669655486",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JC HEALTH CARE SERVICES, 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": "2315 KUEHNER DR",
"SecondLineMailingAddress": "SUITE 112",
"MailingAddressCityName": "SIMI VALLEY",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93063-3900",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "805-527-3527",
"MailingAddressFaxNumber": "805-527-3627",
"FirstLinePracticeLocationAddress": "2315 KUEHNER DR",
"SecondLinePracticeLocationAddress": "SUITE 112",
"PracticeLocationAddressCityName": "SIMI VALLEY",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93063-3900",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "805-390-7165",
"PracticeLocationAddressFaxNumber": "805-823-6219",
"EnumerationDate": "12/15/2007",
"LastUpdateDate": "05/11/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DARBY",
"AuthorizedOfficialFirstName": "ANNIE",
"AuthorizedOfficialMiddleName": "TRAM",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "805-390-7428",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "550001032",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}