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General NPI Number Information
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NPI Number | 1386043297
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Entity Type | Organization
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Legal Business Name | ACROVITA, LLC
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Dates
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Enumeration Date | 08/15/2014
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Last Update Date | 08/15/2014
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Provider Practice Location Address
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Address Line | 11721 SUMMERHAVEN DR
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City | SAINT LOUIS
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State | MO
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Zip | 63146-5443
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Country | US
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Telephone | 314-517-1284
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Fax | 314-432-5382
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Provider Business Mailing Address
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Address Line | PO BOX 410171
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City | SAINT LOUIS
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State | MO
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Zip | 63141-0171
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Country | US
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Telephone | 314-517-1284
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Fax | 314-432-5382
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SARAH TRUEMAN FUEHNE
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Credential | MPT
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Telephone | 314-517-1284
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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 | 2001028985
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License Number State | MO
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