{
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"LastName": null,
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"NamePrefix": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "36 WOBURN ST STE 5",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "READING",
"MailingAddressStateName": "MA",
"MailingAddressPostalCode": "01867-2903",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "617-763-3830",
"MailingAddressFaxNumber": "781-854-0215",
"FirstLinePracticeLocationAddress": "36 WOBURN ST STE LL5",
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"PracticeLocationAddressCityName": "READING",
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"PracticeLocationAddressPostalCode": "01867-2973",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "617-500-3270",
"PracticeLocationAddressFaxNumber": "617-500-3270",
"EnumerationDate": "09/08/2016",
"LastUpdateDate": "10/02/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PINKHAM",
"AuthorizedOfficialFirstName": "JUDITH",
"AuthorizedOfficialMiddleName": "H",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PMP, PHD.",
"AuthorizedOfficialTelephoneNumber": "617-763-3830",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}