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General NPI Number Information
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NPI Number | 1225785256
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Entity Type | Organization
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Legal Business Name | POE MITCH LLC
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Dates
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Enumeration Date | 03/09/2022
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 814 SW EVANGELINE TRWY UNIT 238
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City | LAFAYETTE
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State | LA
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Zip | 70501-8240
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Country | US
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Telephone | 318-519-1818
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5135
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City | BOSSIER CITY
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State | LA
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Zip | 71171-5135
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Country | US
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Telephone | 318-519-1818
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TINA MITCHELL
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Credential |
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Telephone | 318-519-1818
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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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