{
"Npi": {
"NPI": "1841720570",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ELDORADO HEALTHCARE MANAGEMENT, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4991 CORLISS RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LYNDHURST",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44124-1130",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "216-704-7337",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "325 ALPHA PARK",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HIGHLAND HTS",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44143-2237",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "217-704-7337",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/15/2017",
"LastUpdateDate": "06/15/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ISKHAKOVA",
"AuthorizedOfficialFirstName": "ZHANNA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/DON",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "216-704-7337",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}