{
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"EIN": null,
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"FirstLineMailingAddress": "PO BOX 12777",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JACKSONVILLE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32209-0777",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "904-418-4781",
"MailingAddressFaxNumber": "904-485-8167",
"FirstLinePracticeLocationAddress": "1151 W 29TH ST",
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"PracticeLocationAddressCityName": "JACKSONVILLE",
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"PracticeLocationAddressFaxNumber": "904-485-8167",
"EnumerationDate": "08/24/2017",
"LastUpdateDate": "08/24/2017",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}