{
"Npi": {
"NPI": "1801142047",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "AVID HOME HEALTH, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8906 WALL ST",
"SecondLineMailingAddress": "BLDG. 3 SUITE 304",
"MailingAddressCityName": "AUSTIN",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78754-4541",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "512-300-0876",
"MailingAddressFaxNumber": "512-300-0871",
"FirstLinePracticeLocationAddress": "8906 WALL ST",
"SecondLinePracticeLocationAddress": "BLDG. 3 SUITE 304",
"PracticeLocationAddressCityName": "AUSTIN",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78754-4541",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "512-300-0876",
"PracticeLocationAddressFaxNumber": "512-300-0871",
"EnumerationDate": "07/25/2012",
"LastUpdateDate": "01/05/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OKEREKE",
"AuthorizedOfficialFirstName": "APPOLONIA",
"AuthorizedOfficialMiddleName": "O",
"AuthorizedOfficialTitle": "CFO, ALT ADMIN/DON",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "512-300-0876",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}