{
"Npi": {
"NPI": "1790046795",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PEAK HOME HEALTH 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": "8684 CONNECTICUT ST",
"SecondLineMailingAddress": "SUITE A2",
"MailingAddressCityName": "MERRILLVILLE",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "46410-5580",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "219-472-9820",
"MailingAddressFaxNumber": "219-472-9821",
"FirstLinePracticeLocationAddress": "8684 CONNECTICUT ST",
"SecondLinePracticeLocationAddress": "SUITE A2",
"PracticeLocationAddressCityName": "MERRILLVILLE",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "46410-5580",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "219-472-9820",
"PracticeLocationAddressFaxNumber": "219-472-9821",
"EnumerationDate": "06/06/2012",
"LastUpdateDate": "03/25/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OGLESBY ODOM",
"AuthorizedOfficialFirstName": "GWENDOLYN",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "219-472-9820",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "120128881",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}