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General NPI Number Information
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NPI Number | 1063942290
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Entity Type | Organization
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Legal Business Name | RASPBERRY HILL ADULT DAYTIME CENTER
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Dates
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Enumeration Date | 06/20/2017
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 1381 CROSSINGS CENTER DR STE A
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City | FOREST
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State | VA
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Zip | 24551-4971
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Country | US
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Telephone | 434-525-4422
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Fax | 434-534-3460
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Provider Business Mailing Address
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Address Line | 1381 CROSSINGS CENTER DR STE A
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City | FOREST
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State | VA
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Zip | 24551-4971
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Country | US
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Telephone | 434-525-4422
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Fax | 434-534-3460
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MR. EDWARD ARCHER
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Credential | RN
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Telephone | 434-525-4422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001212629
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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