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General NPI Number Information
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NPI Number | 1477988939
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Entity Type | Organization
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Legal Business Name | CARE PROVIDERS AT HOME LLC
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Dates
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Enumeration Date | 09/03/2013
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 6021 MIDNIGHT PASS RD SUITE 11
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City | SARASOTA
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State | FL
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Zip | 34242-3213
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Country | US
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Telephone | 941-349-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 602 TREASURE BOAT WAY
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City | SARASOTA
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State | FL
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Zip | 34242-1412
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Country | US
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Telephone | 941-349-7100
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MR. JAMES E GRIMES
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Credential | R.N., B.S.N.
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Telephone | 941-349-7100
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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 | 233157
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License Number State | FL
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