{
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"EIN": null,
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"IsOrgSubpart": "N",
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"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"Credential": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1317 NAPA CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CROWN POINT",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "46307-2529",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "219-663-4858",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1317 NAPA CT",
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"PracticeLocationAddressCityName": "CROWN POINT",
"PracticeLocationAddressStateName": "IN",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/07/2011",
"LastUpdateDate": "03/08/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VILLAROSA",
"AuthorizedOfficialFirstName": "VICTOR",
"AuthorizedOfficialMiddleName": "I.",
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"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "RN",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}