{
"Npi": {
"NPI": "1972164119",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NORTHERN VIRGINIA SENIOR CAREGIVERS CO",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 1700",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LEESBURG",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "20177-1700",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "540-409-4401",
"MailingAddressFaxNumber": "571-258-0112",
"FirstLinePracticeLocationAddress": "158 FRONT ROYAL PIKE STE 103",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WINCHESTER",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22602-4324",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "540-409-4401",
"PracticeLocationAddressFaxNumber": "571-258-0112",
"EnumerationDate": "06/27/2019",
"LastUpdateDate": "03/21/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOORE",
"AuthorizedOfficialFirstName": "TIMOTHY",
"AuthorizedOfficialMiddleName": "F",
"AuthorizedOfficialTitle": "DIRECTOR / OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "571-258-0111",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}