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General NPI Number Information
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NPI Number | 1124392196
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Entity Type | Organization
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Legal Business Name | ROSE VIEW LLC
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Dates
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Enumeration Date | 03/08/2012
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Last Update Date | 03/08/2012
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Provider Practice Location Address
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Address Line | 303 N MAIN ST
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City | MOUNT VERNON
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State | OH
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Zip | 43050-2045
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Country | US
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Telephone | 419-526-0124
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Fax | 419-522-4391
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Provider Business Mailing Address
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Address Line | 303 N MAIN ST
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City | MOUNT VERNON
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State | OH
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Zip | 43050-2045
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Country | US
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Telephone | 419-526-0124
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Fax | 419-522-4391
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Authorized Official
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Title or Position | COO/OWNER
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Name | MR. MICHAEL L DAFFIN
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Credential |
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Telephone | 419-526-0124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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