{
"Npi": {
"NPI": "1891445789",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "1ST ANGEL HOME HEALTHCARE LLC",
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"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8644 GOLF LANE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COMMERCE TOWNSHIP",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48382-3493",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "602-545-8927",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8344 HALL RD STE 210A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "UTICA",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48317-5554",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "248-464-4920",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/24/2022",
"LastUpdateDate": "03/24/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KALASHO",
"AuthorizedOfficialFirstName": "NASSHAT",
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"AuthorizedOfficialTitle": "OWNER DIRECTOR",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "602-545-8927",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}