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General NPI Number Information
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NPI Number | 1154834984
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Entity Type | Organization
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Legal Business Name | I DECLARE HOMECARE
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Dates
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Enumeration Date | 11/15/2017
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 2350 S JONES BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89146-3103
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Country | US
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Telephone | 702-214-2165
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Fax | 702-214-5801
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Provider Business Mailing Address
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Address Line | 2350 S JONES BLVD STE C3
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City | LAS VEGAS
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State | NV
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Zip | 89146-3103
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Country | US
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Telephone | 702-214-2165
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Fax | 702-214-5801
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Authorized Official
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Title or Position | OWNER
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Name | MS. JANET HAZEL HILL
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Credential |
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Telephone | 702-504-4968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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