{
"Npi": {
"NPI": "1851905236",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LYNKS 2 LYFE, 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": "12121 LITTLE RD STE 278",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HUDSON",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34667-2924",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "888-596-5749",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "9601 GENE ST.",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HUDSON",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34669-3863",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "888-596-5740",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/03/2020",
"LastUpdateDate": "09/03/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PENDLETON",
"AuthorizedOfficialFirstName": "NIECHE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "813-526-9797",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251B00000X",
"TaxonomyName": "Case Management Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "311ZA0620X",
"TaxonomyName": "Adult Care Home Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "320600000X",
"TaxonomyName": "Intellectual and/or Developmental Disabilities Residential Treatment Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "385H00000X",
"TaxonomyName": "Respite Care",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}