{"npi":"1003465626","type":"NPI-2","status":"active","name":{"display":"Peniston Personal Care Home, LLC","other":[],"organization_name":"PENISTON PERSONAL CARE HOME,LLC","authorised_official":"Breezy Houston"},"specialty":{"primary_taxonomy":"251E00000X","primary_taxonomy_description":"Home Health Agency","slug":"home-health-agency","schema_org_specialty":null,"all":[{"code":"163WH0200X","description":"Home Health Registered Nurse","primary":false,"state":null,"license":null},{"code":"374U00000X","description":"Home Health Aide","primary":false,"state":null,"license":null},{"code":"251E00000X","description":"Home Health Agency","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"4680 SUNDRIDGE TRL","city":"FAIRBURN","state":"GA","postal_code":"302131997","country_code":"US","phone":"6785453934","fax":"7708921051"},{"purpose":"MAILING","street_1":"4680 SUNDRIDGE TRL","city":"FAIRBURN","state":"GA","postal_code":"302131997","country_code":"US","phone":"6785453934","fax":"7708921051"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"003217267B","state":"GA","issuer":null},{"type_code":"05","label":"Medicaid","value":"003217267A","state":"GA","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2019-09-06","last_updated":"2023-05-18","_meta":{"source":"NPPES","snapshot_date":"2023-05-18","doc_url":"https://findmynpi.com/api"}}