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General NPI Number Information
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NPI Number | 1427350123
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Entity Type | Organization
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Legal Business Name | AT HOME HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 12/01/2010
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Last Update Date | 12/07/2010
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Provider Practice Location Address
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Address Line | 22 MONUMENT RD SUITE 100
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City | SUMMERTOWN
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State | TN
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Zip | 38483-7644
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Country | US
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Telephone | 931-964-4500
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Fax | 931-964-4533
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Provider Business Mailing Address
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Address Line | 22 MONUMENT RD. SUITE 100
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City | SUMMERTOWN
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State | TN
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Zip | 38483-0000
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Country | US
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Telephone | 931-964-4500
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Fax | 931-964-4533
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | MRS. VALERIE JILL MCDONALD
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Credential |
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Telephone | 931-964-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 167439143
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License Number State | TN
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