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NPI 1457129173

NPI 1457129173 : P&A AFTERCARE : SOUTHFIELD, MI

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General NPI Number Information
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    NPI Number           |    1457129173
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    Entity Type          |    Organization 
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    Legal Business Name  |    P&A AFTERCARE 
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Dates
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    Enumeration Date     |    12/12/2023
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    Last Update Date     |    12/12/2023
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Provider Practice Location Address
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    Address Line         |    20905 GREENFIELD RD 
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    City                 |    SOUTHFIELD
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    State                |    MI
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    Zip                  |    48075-5360
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    Country              |    US
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    Telephone            |    313-551-3811
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    Fax                  |    313-551-3845
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Provider Business Mailing Address
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    Address Line         |    20905 GREENFIELD RD 
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    City                 |    SOUTHFIELD
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    State                |    MI
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    Zip                  |    48075-5360
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    Country              |    US
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    Telephone            |    313-551-3811
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    Fax                  |    313-551-3845
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MRS. SHARLENE  DAWSON 
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    Credential           |    
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    Telephone            |    313-551-3811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251B00000X
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    Taxonomy Name        |    Case Management Agency
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    License Number       |    
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    License Number State |    
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