{
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ELLAS ANGELS HOMECARE LLC",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
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"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 201",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OCONEE",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "31067-0201",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "145 BRILEY ROAD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OCONEE",
"PracticeLocationAddressStateName": "GA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "478-357-4682",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/30/2026",
"LastUpdateDate": "04/30/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FRALEY",
"AuthorizedOfficialFirstName": "TONYA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "478-357-4682",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}