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General NPI Number Information
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NPI Number | 1235252602
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Entity Type | Organization
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Legal Business Name | LA AMISTAD RESIDENTIAL TREATMENT CENTER LLC
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 05/20/2014
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Provider Practice Location Address
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Address Line | 6601 CENTRAL FLORIDA PKWY
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City | ORLANDO
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State | FL
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Zip | 32821-8064
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Country | US
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Telephone | 407-370-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 N PARK AVE
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City | MAITLAND
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State | FL
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Zip | 32751-6570
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Country | US
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Telephone | 407-370-0111
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Fax |
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Authorized Official
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Title or Position | CFO SR VP
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Name | STEVE FILTON
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Credential |
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Telephone | 610-768-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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