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NPI 1386159101

NPI 1386159101 : CHERISH HOME CARE AGENCY L.L.C. : MACOMB, MI

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General NPI Number Information
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    NPI Number           |    1386159101
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    Entity Type          |    Organization 
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    Legal Business Name  |    CHERISH HOME CARE AGENCY L.L.C. 
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Dates
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    Enumeration Date     |    12/04/2017
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    Last Update Date     |    12/04/2017
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Provider Practice Location Address
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    Address Line         |    21735 CHERRY BLOSSOM CT 
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    City                 |    MACOMB
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    State                |    MI
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    Zip                  |    48044-4391
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    Country              |    US
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    Telephone            |    586-404-3114
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    Fax                  |    810-213-9825
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Provider Business Mailing Address
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    Address Line         |    21735 CHERRY BLOSSOM CT 
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    City                 |    MACOMB
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    State                |    MI
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    Zip                  |    48044-4391
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    Country              |    US
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    Telephone            |    586-404-3114
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    Fax                  |    810-213-9825
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Authorized Official
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    Title or Position    |    OWNER-MEMBER
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    Name                 |    MRS. KRYSTAL  WILLIAMS-CAPARAOTTA 
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    Credential           |    
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    Telephone            |    586-404-3114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    253Z00000X
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    Taxonomy Name        |    In Home Supportive Care Agency
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    License Number       |    
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    License Number State |    
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