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General NPI Number Information
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NPI Number | 1497969455
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Entity Type | Organization
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Legal Business Name | ECUMEN HOME CARE
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6001 EARLE BROWN DR
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City | BROOKLYN CENTER
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State | MN
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Zip | 55430-2522
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Country | US
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Telephone | 763-566-1495
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Fax |
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Provider Business Mailing Address
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Address Line | 3530 LEXINGTON AVE N
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City | SHOREVIEW
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State | MN
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Zip | 55126-8164
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Country | US
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Telephone | 651-766-4300
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KATHRYN R ROBERTS
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Credential |
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Telephone | 651-766-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 332750
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License Number State | MN
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