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General NPI Number Information
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NPI Number | 1326268129
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Entity Type | Organization
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Legal Business Name | REALISTIC HOME HEALTH CARE, INC.
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4612 NEWBERRY TER
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City | SAINT LOUIS
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State | MO
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Zip | 63113-2413
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Country | US
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Telephone | 314-535-1616
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Fax | 314-534-9871
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Provider Business Mailing Address
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Address Line | 4612 NEWBERRY TER
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City | SAINT LOUIS
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State | MO
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Zip | 63113-2413
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | EILEEN WEST
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Credential |
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Telephone | 314-535-1616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 0003061
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License Number State | MO
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