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NPI 1225836083

NPI 1225836083 : SERENITY SIGNATURE HEALTH LLC : BOLINGBROOK, IL

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General NPI Number Information
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    NPI Number           |    1225836083
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    Entity Type          |    Organization 
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    Legal Business Name  |    SERENITY SIGNATURE HEALTH LLC 
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Dates
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    Enumeration Date     |    03/06/2025
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    Last Update Date     |    03/06/2025
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Provider Practice Location Address
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    Address Line         |    308 AUTUMN WIND CT 
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    City                 |    BOLINGBROOK
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    State                |    IL
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    Zip                  |    60440-2887
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    Country              |    US
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    Telephone            |    331-229-0804
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    308 AUTUMN WIND CT 
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    City                 |    BOLINGBROOK
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    State                |    IL
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    Zip                  |    60440-2887
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    Country              |    US
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    Telephone            |    331-229-0804
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     ERIC T ROBINSON 
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    Credential           |    
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    Telephone            |    331-229-0804
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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       |    
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    License Number State |    
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