{
"Npi": {
"NPI": "1982225546",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "WOFFORD AND WILLIAMS INC",
"ParentOrgTIN": null,
"OrgName": "WOFFORD AND WILLIAMS INC",
"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": "5405 QUARTER POLE LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOPE MILLS",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28348-8355",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "910-568-5319",
"MailingAddressFaxNumber": "910-491-9719",
"FirstLinePracticeLocationAddress": "5405 QUARTER POLE LN",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HOPE MILLS",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28348-8355",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "910-568-5319",
"PracticeLocationAddressFaxNumber": "910-491-9719",
"EnumerationDate": "05/05/2020",
"LastUpdateDate": "09/14/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WOFFORD",
"AuthorizedOfficialFirstName": "LASHONDA",
"AuthorizedOfficialMiddleName": "RENEE",
"AuthorizedOfficialTitle": "CHIEF EXECUTIVE OFFICER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "910-568-5319",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251J00000X",
"TaxonomyName": "Nursing Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "376K00000X",
"TaxonomyName": "Nurse's Aide",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "385H00000X",
"TaxonomyName": "Respite Care",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "385HR2060X",
"TaxonomyName": "Child Intellectual and/or Developmental Disabilities Respite Care",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "385HR2065X",
"TaxonomyName": "Child Physical Disabilities Respite Care",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}