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General NPI Number Information
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NPI Number | 1356864466
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Entity Type | Organization
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Legal Business Name | CARECONNECT HEALTH SERVICES LLC
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Dates
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Enumeration Date | 07/20/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 44 28TH AVE N LOWR 46
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City | SAINT CLOUD
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State | MN
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Zip | 56303-4588
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Country | US
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Telephone | 952-994-4402
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Fax | 218-216-1111
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Provider Business Mailing Address
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Address Line | 44 28TH AVE N LOWR 46
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City | SAINT CLOUD
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State | MN
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Zip | 56303-4588
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Country | US
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Telephone | 952-994-4402
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Fax | 218-216-1111
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MUSTAF ABDIRAHMAN HASSAN
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Credential |
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Telephone | 952-994-4402
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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 |
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License Number State |
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