{
"Npi": {
"NPI": "1780929075",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ELITE GARDEN HOMES, 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": "10501 W BRADLEY RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MILWAUKEE",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "53224-2673",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "414-459-3275",
"MailingAddressFaxNumber": "414-434-4207",
"FirstLinePracticeLocationAddress": "11414 W PARK PL",
"SecondLinePracticeLocationAddress": "SUITE 202",
"PracticeLocationAddressCityName": "MILWAUKEE",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "53224-3500",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "414-459-3275",
"PracticeLocationAddressFaxNumber": "414-434-4207",
"EnumerationDate": "11/28/2012",
"LastUpdateDate": "11/28/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SONA",
"AuthorizedOfficialFirstName": "JERRY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CEO",
"AuthorizedOfficialTelephoneNumber": "414-241-5019",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "1157",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}