{
"Npi": {
"NPI": "1932634375",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ANGELIC HOMECARE LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6319 CASTLE PL STE C",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FALLS CHURCH",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22044-1907",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "202-779-8424",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "13800 COPPERMINE ROAD",
"SecondLinePracticeLocationAddress": "SUITE 175",
"PracticeLocationAddressCityName": "HERNDON",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "20171",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "202-779-8424",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/24/2017",
"LastUpdateDate": "09/06/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TANYI",
"AuthorizedOfficialFirstName": "VICTORINE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "202-779-8424",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}