{
"Npi": {
"NPI": "1912797218",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BEAUVAIS HEALTH HOMECARE 3 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": "111 NORTHFIELD AVE STE 208A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WEST ORANGE",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07052-4730",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "973-436-5862",
"MailingAddressFaxNumber": "973-537-1006",
"FirstLinePracticeLocationAddress": "111 NORTHFIELD AVE STE 208A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WEST ORANGE",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07052-4730",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "973-436-5862",
"PracticeLocationAddressFaxNumber": "973-537-1006",
"EnumerationDate": "05/09/2025",
"LastUpdateDate": "05/09/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BEAUVAIS",
"AuthorizedOfficialFirstName": "WILDA",
"AuthorizedOfficialMiddleName": "B.",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "973-436-5862",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QS1000X",
"TaxonomyName": "Student Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251J00000X",
"TaxonomyName": "Nursing Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QI0500X",
"TaxonomyName": "Infusion Therapy Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}