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General NPI Number Information
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NPI Number | 1508432659
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Entity Type | Organization
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Legal Business Name | BLOOM HOSPICE LLC
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Dates
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Enumeration Date | 05/30/2021
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Last Update Date | 05/30/2021
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Provider Practice Location Address
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Address Line | 8125 N SAM HOUSTON PKWY W STE B-2
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City | HOUSTON
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State | TX
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Zip | 77064-3450
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Country | US
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Telephone | 346-409-6361
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Fax | 346-214-7100
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Provider Business Mailing Address
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Address Line | 8125 N SAM HOUSTON PKWY W STE B-2
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City | HOUSTON
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State | TX
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Zip | 77064-3450
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Country | US
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Telephone | 346-409-6361
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Fax | 346-214-7100
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Authorized Official
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Title or Position | ALTERNATE ADMINISTRATOR
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Name | MR. WALEED LAKHANI
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Credential | MSW
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Telephone | 346-409-6361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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