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General NPI Number Information
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NPI Number | 1144746454
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Entity Type | Organization
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Legal Business Name | SKYCARE SERVICES
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Dates
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Enumeration Date | 08/17/2017
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Last Update Date | 08/17/2017
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Provider Practice Location Address
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Address Line | 3119 SPRING GLEN RD
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City | JACKSONVILLE
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State | FL
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Zip | 32207-5914
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Country | US
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Telephone | 201-852-2309
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Fax |
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Provider Business Mailing Address
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Address Line | 1273 EBENEZER RD STE C
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City | ROCK HILL
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State | SC
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Zip | 29732-2353
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Country | US
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Telephone | 803-587-8036
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MS. QUIANA MESHELL DIXON
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Credential |
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Telephone | 201-852-2309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | FL
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