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NPI 1437969771

NPI 1437969771 : SENIOR HOME CARE LA : AGUA DULCE, CA

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General NPI Number Information
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    NPI Number           |    1437969771
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    Entity Type          |    Organization 
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    Legal Business Name  |    SENIOR HOME CARE LA 
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Dates
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    Enumeration Date     |    01/09/2025
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    Last Update Date     |    01/09/2025
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Provider Practice Location Address
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    Address Line         |    31912 AVENIDA DEL REY 
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    City                 |    AGUA DULCE
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    State                |    CA
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    Zip                  |    91390-4528
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    Country              |    US
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    Telephone            |    818-888-6940
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    31912 AVENIDA DEL REY 
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    City                 |    AGUA DULCE
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    State                |    CA
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    Zip                  |    91390-4528
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    Country              |    US
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    Telephone            |    818-888-6940
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    Fax                  |    
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Authorized Official
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    Title or Position    |    GENERAL MANAGER
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    Name                 |     KRISTEN  VERNON 
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    Credential           |    
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    Telephone            |    818-888-6940
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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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