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General NPI Number Information
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NPI Number | 1144761313
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Entity Type | Organization
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Legal Business Name | HEALEN HANDZ IN-HOME CARE LLC
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Dates
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Enumeration Date | 03/20/2017
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Last Update Date | 03/20/2017
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Provider Practice Location Address
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Address Line | 4144 LINDELL BLVD SUITE 404
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City | SAINT LOUIS
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State | MO
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Zip | 63108-2927
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Country | US
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Telephone | 314-899-0600
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Fax | 314-899-0601
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Provider Business Mailing Address
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Address Line | 4144 LINDELL BLVD SUITE 404
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City | SAINT LOUIS
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State | MO
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Zip | 63108-2927
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Country | US
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Telephone | 314-899-0600
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Fax | 314-899-0601
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. SHANTAY RENEE CHARLESTON
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Credential |
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Telephone | 314-899-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | LC001492224
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License Number State | MO
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