{
"Npi": {
"NPI": "1861451841",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GIDDA'S HOME HEALTH SERVICES, INC.",
"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": "13351 HAWTHORNE BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HAWTHORNE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90250-5802",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "310-644-0985",
"MailingAddressFaxNumber": "310-644-5566",
"FirstLinePracticeLocationAddress": "13351 HAWTHORNE BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HAWTHORNE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90250-5802",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "310-644-0985",
"PracticeLocationAddressFaxNumber": "310-644-5566",
"EnumerationDate": "03/20/2006",
"LastUpdateDate": "10/27/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TIMBO",
"AuthorizedOfficialFirstName": "ISATU",
"AuthorizedOfficialMiddleName": "NENEH",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MISS",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "310-644-0985",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "980001490",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}