{
"Npi": {
"NPI": "1851552855",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SAMUELSON PERSONAL CARE 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": "1411 NE 22ND AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OCALA",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34470-7733",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "352-622-6447",
"MailingAddressFaxNumber": "352-622-5578",
"FirstLinePracticeLocationAddress": "1411 NE 22ND AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OCALA",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34470-7733",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "352-622-6447",
"PracticeLocationAddressFaxNumber": "352-622-5578",
"EnumerationDate": "06/23/2008",
"LastUpdateDate": "06/23/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SAMUELSON",
"AuthorizedOfficialFirstName": "JIM",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "FRANCHISE OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "352-622-6447",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "299993167",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}