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General NPI Number Information
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NPI Number | 1376648766
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Entity Type | Organization
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Legal Business Name | COUNTRY STYLE HEALTH CARE, LLC
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 7800 SHOAL CREEK BLVD STE 118W
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City | AUSTIN
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State | TX
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Zip | 78757-1007
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Country | US
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Telephone | 512-374-0700
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Fax | 512-374-0740
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Provider Business Mailing Address
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Address Line | 34 35TH ST UNIT 4
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City | BROOKLYN
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State | NY
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Zip | 11232-2212
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Country | US
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Telephone | 718-748-5908
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. DAVID ALBERT
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Credential |
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Telephone | 718-748-5908
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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 | 015151
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License Number State | TX
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