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NPI 1104794569

NPI 1104794569 : ENAT HOMECARE LLC : FITCHBURG, WI

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General NPI Number Information
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    NPI Number           |    1104794569
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    Entity Type          |    Organization 
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    Legal Business Name  |    ENAT HOMECARE LLC 
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Dates
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    Enumeration Date     |    10/28/2025
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    Last Update Date     |    10/28/2025
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Provider Practice Location Address
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    Address Line         |    2325 APACHE DR 
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    City                 |    FITCHBURG
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    State                |    WI
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    Zip                  |    53711-4702
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    Country              |    US
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    Telephone            |    608-213-7895
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2325 APACHE DR 
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    City                 |    FITCHBURG
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    State                |    WI
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    Zip                  |    53711-4702
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    Country              |    US
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    Telephone            |    608-213-7895
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     MARON MARKOS REGASSA 
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    Credential           |    
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    Telephone            |    608-213-7895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    374U00000X
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    Taxonomy Name        |    Home Health Aide
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    License Number       |    
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    License Number State |    
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