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General NPI Number Information
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NPI Number | 1346683380
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Entity Type | Organization
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Legal Business Name | RAY OF HOPE HEALTH CARE AGENCY LLC
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Dates
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Enumeration Date | 04/09/2013
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 5701 S WESTERN AVE STE 10A
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City | LOS ANGELES
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State | CA
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Zip | 90062-2714
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Country | US
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Telephone | 626-367-6987
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Fax |
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Provider Business Mailing Address
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Address Line | 5701 S WESTERN AVE STE 10A
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City | LOS ANGELES
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State | CA
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Zip | 90062-2714
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Country | US
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Telephone | 626-367-6987
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Fax |
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Authorized Official
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Title or Position | OWNER/CFO
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Name | BONITA D HACKWORTH
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Credential |
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Telephone | 626-367-6987
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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 | 201308210660
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License Number State | CA
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