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General NPI Number Information
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NPI Number | 1306130281
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Entity Type | Organization
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Legal Business Name | MORSELIFE HOSPICE INSTITUTE, INC.
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Dates
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Enumeration Date | 06/08/2011
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Last Update Date | 02/20/2019
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Provider Practice Location Address
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Address Line | 4855 FRED GLADSTONE DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33417
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Country | US
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Telephone | 561-736-0294
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Fax | 561-369-3544
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Provider Business Mailing Address
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Address Line | 4847 DAVID S MACK DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-8023
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Country | US
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Telephone | 561-209-6108
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Fax | 651-689-8718
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Authorized Official
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Title or Position | CONTROLLER
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Name | RANDY WOLAN
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Credential |
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Telephone | 561-209-6108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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