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NPI 1336080787

NPI 1336080787 : AZALEA'S OF AUTUMN HOME CARE AGENCY LLC : STOUGHTON, MA

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General NPI Number Information
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    NPI Number           |    1336080787
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    Entity Type          |    Organization 
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    Legal Business Name  |    AZALEA'S OF AUTUMN HOME CARE AGENCY LLC 
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Dates
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    Enumeration Date     |    04/01/2026
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    Last Update Date     |    04/01/2026
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Provider Practice Location Address
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    Address Line         |    1266 BAY RD 
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    City                 |    STOUGHTON
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    State                |    MA
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    Zip                  |    02072-3958
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    Country              |    US
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    Telephone            |    774-297-9394
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1266 BAY RD 
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    City                 |    STOUGHTON
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    State                |    MA
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    Zip                  |    02072-3958
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    Country              |    US
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    Telephone            |    774-297-9394
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     SHEVONNE DANIELLE TAYLOR 
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    Credential           |    
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    Telephone            |    774-297-9394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    374U00000X
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    Taxonomy Name        |    Home Health Aide
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    License Number       |    
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    License Number State |    
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