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General NPI Number Information
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NPI Number | 1417351495
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Entity Type | Organization
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Legal Business Name | OPTIMUM CARE SERVICES, LLC.
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Dates
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Enumeration Date | 10/20/2014
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Last Update Date | 10/18/2017
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Provider Practice Location Address
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Address Line | 72 MORRIS DR
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-4405
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Country | US
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Telephone | 732-331-5627
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Fax |
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Provider Business Mailing Address
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Address Line | 72 MORRIS DR
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-4405
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Country | US
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Telephone | 973-818-0145
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Fax |
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Authorized Official
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Title or Position | MANAGER/ADMINISTRATOR
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Name | AYODEJI L ONIBUORE
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Credential | BSC
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Telephone | 973-818-0145
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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 | HP0195801
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License Number State | NJ
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