{
"Npi": {
"NPI": "1801229018",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GUARDIAN ANGEL HOME HEALTH",
"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": "211 N UNION ST",
"SecondLineMailingAddress": "#100 OLD TOWN",
"MailingAddressCityName": "ALEXANDRIA",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22314-2657",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "703-519-1255",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "211 N UNION ST",
"SecondLinePracticeLocationAddress": "#100 OLD TOWN",
"PracticeLocationAddressCityName": "ALEXANDRIA",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22314-2657",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "703-519-1255",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/12/2013",
"LastUpdateDate": "09/23/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OTUYA",
"AuthorizedOfficialFirstName": "CHIYERE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "NURSING DIRECTOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "REGISTERED NURSE",
"AuthorizedOfficialTelephoneNumber": "240-462-9940",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "4626066468",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}