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General NPI Number Information
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NPI Number | 1114197571
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Entity Type | Organization
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Legal Business Name | KENZIE KARE GROUP HOME
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Dates
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Enumeration Date | 03/01/2008
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 919 5TH AVE
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City | LEHIGH ACRES
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State | FL
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Zip | 33972-2921
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Country | US
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Telephone | 239-369-6448
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Fax | 239-902-9887
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Provider Business Mailing Address
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Address Line | 919 5TH AVE
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City | LEHIGH ACRES
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State | FL
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Zip | 33972-2921
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Country | US
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Telephone | 239-369-6448
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Fax | 239-902-9887
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Authorized Official
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Title or Position | CEO
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Name | MRS. CASSANDRA ELIZABETH MCKENZIE
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Credential | REGISTERED NURSE MSN
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Telephone | 239-834-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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