{
"Npi": {
"NPI": "1891796850",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ADVANTAGE SKILLED CARE, L.L.C.",
"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": "1656 COLES BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PORTSMOUTH",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45662-2632",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "740-354-5671",
"MailingAddressFaxNumber": "740-354-4432",
"FirstLinePracticeLocationAddress": "4292 OLD SCIOTO TRL",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PORTSMOUTH",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "45662-6641",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "740-354-5671",
"PracticeLocationAddressFaxNumber": "740-354-4432",
"EnumerationDate": "08/02/2005",
"LastUpdateDate": "08/09/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VALLEE",
"AuthorizedOfficialFirstName": "MICHAEL",
"AuthorizedOfficialMiddleName": "S",
"AuthorizedOfficialTitle": "PRESIDENT/ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "740-354-5671",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "52643260",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}