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General NPI Number Information
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NPI Number | 1326979899
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Entity Type | Organization
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Legal Business Name | PORTAGE CARE LIVING LLC
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Dates
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Enumeration Date | 05/26/2026
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Last Update Date | 05/26/2026
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Provider Practice Location Address
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Address Line | 822 W PLEASANT ST
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City | PORTAGE
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State | WI
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Zip | 53901-1928
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Country | US
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Telephone | 612-300-4685
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Fax |
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Provider Business Mailing Address
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Address Line | 822 W PLEASANT ST
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City | PORTAGE
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State | WI
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Zip | 53901-1928
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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 | MANAGER
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Name | SADIA NOUR
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Credential |
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Telephone | 612-300-4685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2278H0200X
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Taxonomy Name | Home Health Certified Respiratory Therapist
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License Number |
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License Number State |
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