{
"Npi": {
"NPI": "1912387457",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ABBY HEALTHCARE SERVICES",
"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": "550 WRENHAVEN CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOGANVILLE",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30052-6232",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "470-535-1524",
"MailingAddressFaxNumber": "678-580-5491",
"FirstLinePracticeLocationAddress": "2151 FOUNTAIN DR STE 201",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SNELLVILLE",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30078-6753",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "678-615-7258",
"PracticeLocationAddressFaxNumber": "678-615-7258",
"EnumerationDate": "05/30/2015",
"LastUpdateDate": "03/04/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AJALA",
"AuthorizedOfficialFirstName": "OLUFUNMILAYO",
"AuthorizedOfficialMiddleName": "T",
"AuthorizedOfficialTitle": "DIRECTOR OF NURSING (DON)",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "REGISTERED NURSE",
"AuthorizedOfficialTelephoneNumber": "470-435-5341",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "RN222212",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251J00000X",
"TaxonomyName": "Nursing Care Agency",
"LicenseNumber": "RN222212",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}