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General NPI Number Information
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NPI Number | 1255404448
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Entity Type | Organization
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Legal Business Name | WILLIAM B RICE EVENTIDE HOME
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 11/23/2016
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Provider Practice Location Address
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Address Line | 25 STONEHAVEN DR
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City | WEYMOUTH
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State | MA
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Zip | 02190-3926
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Country | US
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Telephone | 781-660-5000
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Fax | 781-660-5001
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Provider Business Mailing Address
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Address Line | 25 STONEHAVEN DR
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City | WEYMOUTH
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State | MA
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Zip | 02190-3926
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Country | US
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Telephone | 781-660-5000
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Fax | 781-660-5001
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Authorized Official
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Title or Position | CEO
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Name | MS. JOYCE D HAGLUND
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Credential |
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Telephone | 781-660-5010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0437
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License Number State | MA
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