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General NPI Number Information
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NPI Number | 1255333753
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Entity Type | Organization
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Legal Business Name | HOSPICE OF THE WESTERN RESERVE, INC.
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 08/21/2018
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Provider Practice Location Address
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Address Line | 300 E 185TH ST
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City | CLEVELAND
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State | OH
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Zip | 44119
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Country | US
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Telephone | 216-383-2222
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Fax | 216-383-3750
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Provider Business Mailing Address
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Address Line | 17876 SAINT CLAIR AVE
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City | CLEVELAND
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State | OH
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Zip | 44110-2602
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Country | US
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Telephone | 216-383-2222
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Fax | 216-298-0241
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. WILLIAM FINN
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Credential | CEO
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Telephone | 216-383-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 0003-HSP
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2080H0002X
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Taxonomy Name | Pediatric Hospice and Palliative Medicine Physician
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License Number |
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License Number State |
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