{
"Npi": {
"NPI": "1962433490",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "AMIGO HOME HEALTH AGENCY, 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": "PO BOX 175",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WESLACO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78599-0175",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "956-968-8530",
"MailingAddressFaxNumber": "956-969-9502",
"FirstLinePracticeLocationAddress": "316 N TEXAS BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WESLACO",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78596-5306",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "956-968-8530",
"PracticeLocationAddressFaxNumber": "956-969-9502",
"EnumerationDate": "07/05/2006",
"LastUpdateDate": "12/27/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VARELA",
"AuthorizedOfficialFirstName": "EDELMIRO",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO / PRESIDENT/ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "R.N.",
"AuthorizedOfficialTelephoneNumber": "956-968-8530",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "007809",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}