{
"Npi": {
"NPI": "1962520635",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "DIVINE HOME CARE, LLC",
"ParentOrgTIN": null,
"OrgName": "DIVINE HOME CARE, LLC",
"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": "751 S MAIN ST",
"SecondLineMailingAddress": "SUITE B",
"MailingAddressCityName": "RAEFORD",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28376-3238",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "910-904-2377",
"MailingAddressFaxNumber": "910-904-2477",
"FirstLinePracticeLocationAddress": "751 S MAIN ST",
"SecondLinePracticeLocationAddress": "SUITE B",
"PracticeLocationAddressCityName": "RAEFORD",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28376-3238",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "910-904-2377",
"PracticeLocationAddressFaxNumber": "910-904-2477",
"EnumerationDate": "03/27/2007",
"LastUpdateDate": "05/06/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FLEMING",
"AuthorizedOfficialFirstName": "FLORINE",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "OWNER, SERVICE DIRECTOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "910-904-2377",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "HC2882",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}