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General NPI Number Information
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NPI Number | 1396468773
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Entity Type | Organization
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Legal Business Name | 4 EVER BLESSINGSHOME CARE CORP
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Dates
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Enumeration Date | 09/21/2022
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Last Update Date | 09/21/2022
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Provider Practice Location Address
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Address Line | 2306 LOCUST AVE
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City | RONKONKOMA
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State | NY
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Zip | 11779-6522
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Country | US
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Telephone | 631-833-5577
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Fax | 631-615-6160
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Provider Business Mailing Address
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Address Line | 200 HAWKINS AVE UNIT 1166
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City | RONKONKOMA
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State | NY
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Zip | 11779-8019
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Country | US
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Telephone | 631-939-1901
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Fax |
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Authorized Official
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Title or Position | EMPLOYEE/OWNER
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Name | MS. FAYE ANNETTE HENDERSON
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Credential |
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Telephone | 631-833-5577
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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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