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General NPI Number Information
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NPI Number | 1205333978
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Entity Type | Organization
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Legal Business Name | HEARTFELT RESIDENTIAL CARE, LLC
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Dates
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Enumeration Date | 04/10/2018
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Last Update Date | 04/10/2018
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Provider Practice Location Address
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Address Line | 22430 HAWTHORNE ST
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City | FARMINGTON HILLS
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State | MI
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Zip | 48336-4323
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Country | US
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Telephone | 800-379-4201
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Fax |
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Provider Business Mailing Address
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Address Line | 37637 5 MILE RD # 392
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City | LIVONIA
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State | MI
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Zip | 48154-1543
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Country | US
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Telephone | 800-379-4201
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DEREK ROBBINS
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Credential |
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Telephone | 800-379-4201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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