{
"Npi": {
"NPI": "1689925752",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NBA HEALTHCARE",
"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": "1811 SHERMAN DR",
"SecondLineMailingAddress": "SUITE 3",
"MailingAddressCityName": "SAINT CHARLES",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63303-3976",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "636-866-0722",
"MailingAddressFaxNumber": "636-866-0729",
"FirstLinePracticeLocationAddress": "1811 SHERMAN DR",
"SecondLinePracticeLocationAddress": "SUITE 3",
"PracticeLocationAddressCityName": "SAINT CHARLES",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "63303-3976",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "636-866-0722",
"PracticeLocationAddressFaxNumber": "636-866-0729",
"EnumerationDate": "09/28/2012",
"LastUpdateDate": "09/28/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ALLEN",
"AuthorizedOfficialFirstName": "WILLIAM",
"AuthorizedOfficialMiddleName": "H",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "636-866-0722",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "21643369",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}