{
"Npi": {
"NPI": "1962898601",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "HDMC HOLDINGS, LLC",
"ParentOrgTIN": null,
"OrgName": "HDMC HOLDINGS, 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": "6601 WHITE FEATHER RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JOSHUA TREE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92252-6607",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "760-366-6424",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "6601 WHITE FEATHER RD STE A-5",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "JOSHUA TREE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92252-6607",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "760-366-6424",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/09/2015",
"LastUpdateDate": "03/23/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KING",
"AuthorizedOfficialFirstName": "MIKE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CFO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "209-985-3317",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}