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General NPI Number Information
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NPI Number | 1326559782
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Entity Type | Organization
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Legal Business Name | MOLLISON ADULT DAY CARE INC.
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Dates
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Enumeration Date | 10/12/2017
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Last Update Date | 09/13/2018
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Provider Practice Location Address
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Address Line | 115 S MOLLISON AVE
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City | EL CAJON
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State | CA
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Zip | 92020-4814
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Country | US
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Telephone | 619-551-2133
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Fax |
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Provider Business Mailing Address
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Address Line | 8744 GOLF DR
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City | SPRING VALLEY
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State | CA
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Zip | 91977-1009
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Country | US
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Telephone | 248-819-1422
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Fax | 619-303-7876
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. LOALOA N KARANA SHAMOUN
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Credential | CEO
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Telephone | 619-551-2133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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