{
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"ReplacementNPI": null,
"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ICARE HOME HEALTH AGENCY LLC",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2411 W CHARLESTON BLVD",
"SecondLineMailingAddress": "ST 100",
"MailingAddressCityName": "LAS VEGAS",
"MailingAddressStateName": "NV",
"MailingAddressPostalCode": "89102-2123",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "702-485-2377",
"MailingAddressFaxNumber": "702-485-2979",
"FirstLinePracticeLocationAddress": "2411 W CHARLESTON BLVD",
"SecondLinePracticeLocationAddress": "ST 100",
"PracticeLocationAddressCityName": "LAS VEGAS",
"PracticeLocationAddressStateName": "NV",
"PracticeLocationAddressPostalCode": "89102-2123",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "702-485-2377",
"PracticeLocationAddressFaxNumber": "702-485-2979",
"EnumerationDate": "12/08/2011",
"LastUpdateDate": "05/08/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ADEGBORUWA",
"AuthorizedOfficialFirstName": "LATASHA",
"AuthorizedOfficialMiddleName": "S",
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN, BSN",
"AuthorizedOfficialTelephoneNumber": "702-485-2377",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}