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General NPI Number Information
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NPI Number | 1316229867
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Entity Type | Organization
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Legal Business Name | ASSURANCE RESIDENTIAL CARE
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Dates
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Enumeration Date | 09/11/2011
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Last Update Date | 09/11/2011
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Provider Practice Location Address
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Address Line | 6522 CANDLECANE CIR
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City | SAN ANTONIO
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State | TX
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Zip | 78244-1914
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Country | US
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Telephone | 210-454-3720
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Fax |
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Provider Business Mailing Address
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Address Line | 6522 CANDLECANE CIR
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City | SAN ANTONIO
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State | TX
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Zip | 78244-1914
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Country | US
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Telephone | 210-454-3720
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. AUDREY MOODY
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Credential | LVN
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Telephone | 210-454-3720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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