{
"Npi": {
"NPI": "1770362691",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LACY FAMILY IN HOME CARE, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "400 W CAPITOL AVE STE 1700499",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LITTLE ROCK",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "72201-3436",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "870-377-4852",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "499 CEDAR ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DUMAS",
"PracticeLocationAddressStateName": "AR",
"PracticeLocationAddressPostalCode": "71639-9543",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "870-377-4852",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/28/2023",
"LastUpdateDate": "09/28/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LACY",
"AuthorizedOfficialFirstName": "PIERCE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CO-OWNER/ADMINISTRATOR/CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "870-377-5725",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3747A0650X",
"TaxonomyName": "Attendant Care Provider",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3747P1801X",
"TaxonomyName": "Personal Care Attendant",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}