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General NPI Number Information
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NPI Number | 1427351907
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Entity Type | Organization
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Legal Business Name | AUTUMN EXTENDED CARE FACILITY, INC.
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Dates
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Enumeration Date | 12/06/2010
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Last Update Date | 11/13/2013
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Provider Practice Location Address
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Address Line | 1433 WALNUT ST
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City | COSHOCTON
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State | OH
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Zip | 43812-2263
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Country | US
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Telephone | 740-622-6411
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Fax |
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Provider Business Mailing Address
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Address Line | 23 FORRY ST
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City | NEWARK
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State | OH
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Zip | 43055-4057
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Country | US
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Telephone | 740-345-9919
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Fax | 740-345-7737
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | STEVEN L HITCHENS
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Credential |
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Telephone | 740-345-9199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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