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General NPI Number Information
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NPI Number | 1104392349
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Entity Type | Organization
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Legal Business Name | ORCHID RESIDENTIAL INC.
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Dates
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Enumeration Date | 10/15/2018
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Last Update Date | 10/15/2018
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Provider Practice Location Address
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Address Line | 9580 W ORCHID LN
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City | PEORIA
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State | AZ
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Zip | 85345-7719
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Country | US
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Telephone | 623-440-2428
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Fax | 623-234-1713
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Provider Business Mailing Address
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Address Line | 9305 W CORDES RD
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City | TOLLESON
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State | AZ
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Zip | 85353-1506
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Country | US
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Telephone | 623-313-0827
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MAVU JARICHA
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Credential |
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Telephone | 623-313-0827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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