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General NPI Number Information
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NPI Number | 1457098444
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Entity Type | Organization
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Legal Business Name | SAFARI HEALTH CARE LLC
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Dates
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Enumeration Date | 05/19/2022
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Last Update Date | 05/19/2022
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Provider Practice Location Address
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Address Line | 2350 S JONES BLVD # D5
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City | LAS VEGAS
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State | NV
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Zip | 89146-3103
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Country | US
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Telephone | 702-690-3019
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Fax | 702-847-8832
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Provider Business Mailing Address
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Address Line | 3937 SPENCER ST APT 199
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City | LAS VEGAS
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State | NV
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Zip | 89119-5217
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Country | US
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Telephone | 702-690-3019
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Fax | 702-847-8832
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SUSAN W GACHUMA
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Credential | RN
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Telephone | 508-769-4095
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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 |
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License Number State |
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