{
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"IsOrgSubpart": "N",
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"FirstLineMailingAddress": "2414 GOLF RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PHILADELPHIA",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19131-1417",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "215-473-8151",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2414 GOLF RD",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/10/2019",
"LastUpdateDate": "06/10/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "EKWERIKE",
"AuthorizedOfficialFirstName": "DENIS",
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"AuthorizedOfficialTelephoneNumber": "215-473-8151",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}