{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "PRESERVE HEALTHCARE SERVICES LLC",
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"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"Credential": null,
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"OtherLastName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6007 TILLMAN CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PLEASANTON",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94588-4765",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "925-998-1037",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1633 ALUM ROCK AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN JOSE",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressTelephoneNumber": "925-998-1037",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/07/2019",
"LastUpdateDate": "04/07/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KALU",
"AuthorizedOfficialFirstName": "EKE",
"AuthorizedOfficialMiddleName": "PATRICK",
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"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MBA",
"AuthorizedOfficialTelephoneNumber": "925-998-1037",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}