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General NPI Number Information
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NPI Number | 1043326531
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Entity Type | Organization
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Legal Business Name | COMMUNITY HOSPICE, INC.
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 11/08/2016
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Provider Practice Location Address
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Address Line | 4368 SPYRES WAY
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City | MODESTO
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State | CA
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Zip | 95356-9256
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Country | US
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Telephone | 209-578-6320
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Fax | 209-541-3280
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Provider Business Mailing Address
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Address Line | 4368 SPYRES WAY
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City | MODESTO
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State | CA
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Zip | 95356-9259
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Country | US
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Telephone | 209-578-6300
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Fax | 209-541-3280
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. CHARLOTTE DESHA MCLEOD
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Credential |
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Telephone | 209-578-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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