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General NPI Number Information
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NPI Number | 1356981047
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Entity Type | Organization
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Legal Business Name | FAITH AND FAMILY HOME CARE LLC
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Dates
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Enumeration Date | 01/09/2020
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Last Update Date | 05/13/2020
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Provider Practice Location Address
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Address Line | 3339 GARDENSIDE WALK
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City | LOGANVILLE
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State | GA
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Zip | 30052-7905
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Country | US
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Telephone | 786-376-1360
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Fax |
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Provider Business Mailing Address
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Address Line | 4160 LOGAN DR UNIT 52
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City | LOGANVILLE
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State | GA
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Zip | 30052-9500
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Country | US
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Telephone | 470-622-3962
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VIANA RICHARDS
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Credential |
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Telephone | 470-622-3962
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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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