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General NPI Number Information
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NPI Number | 1376705541
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Entity Type | Organization
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Legal Business Name | SOJOURN INC
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 891 WEST BLVD 321
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City | HARTFORD
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State | CT
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Zip | 06105-4154
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Country | US
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Telephone | 860-904-2796
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 331562
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City | WEST HARTFORD
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State | CT
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Zip | 06133-1562
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Country | US
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Telephone | 860-904-2796
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LUCILLIA WILLSON
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Credential |
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Telephone | 860-904-2796
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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 | HCA0000306
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License Number State | CT
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