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General NPI Number Information
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NPI Number | 1134382955
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Entity Type | Organization
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Legal Business Name | BELL-MYRE'S RESIDENTIAL COMMUNITY CARE FACILITY, LLC
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 1800 MCALISTER ST
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City | CEDAR HILL
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State | TX
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Zip | 75104-4904
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Country | US
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Telephone | 972-293-1085
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Fax | 972-293-1085
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Provider Business Mailing Address
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Address Line | 1800 MCALISTER ST
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City | CEDAR HILL
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State | TX
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Zip | 75104-4904
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Country | US
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Telephone | 972-293-1085
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Fax | 972-293-1085
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Authorized Official
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Title or Position | NURSE
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Name | MS. ROXANNE VIOLA MARIE BELL-MYRE
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Credential | LVN
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Telephone | 972-293-1085
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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 | 198517
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License Number State | TX
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