{
"Npi": {
"NPI": "1841172285",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FULL HOUSE CARE AGENCY 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": "42 CASTLETON DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RICHBORO",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "18954-1672",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "215-268-8108",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "42 CASTLETON DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RICHBORO",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "18954-1672",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "215-268-8108",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/25/2025",
"LastUpdateDate": "07/25/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SANCHAKU",
"AuthorizedOfficialFirstName": "SUELA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "215-268-8108",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}