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General NPI Number Information
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NPI Number | 1477832053
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Entity Type | Organization
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Legal Business Name | FIRST ADVENT MISSION
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Dates
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Enumeration Date | 08/12/2011
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Last Update Date | 08/17/2011
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Provider Practice Location Address
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Address Line | 1055 N 5TH ST UNIT 93
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City | JACKSONVILLE
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State | OR
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Zip | 97530-9654
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Country | US
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Telephone | 541-702-2204
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Fax |
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Provider Business Mailing Address
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Address Line | 1055 N 5TH ST UNIT 93
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City | JACKSONVILLE
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State | OR
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Zip | 97530-9654
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Country | US
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Telephone | 541-702-2204
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Fax |
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Authorized Official
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Title or Position | IN HOME SERVICES
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Name | SHARON LEE SHIELDS
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Credential |
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Telephone | 541-702-2204
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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