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General NPI Number Information
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NPI Number | 1518031962
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Entity Type | Organization
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Legal Business Name | HEART 2 HEART HOSPICE LLC
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Dates
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Enumeration Date | 11/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 220 S 11TH ST
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City | BELLEVILLE
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State | IL
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Zip | 62220-1821
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Country | US
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Telephone | 618-223-6604
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Fax |
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Provider Business Mailing Address
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Address Line | 220 S 11TH ST
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City | BELLEVILLE
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State | IL
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Zip | 62220-1821
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Country | US
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Telephone | 618-223-6604
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TONYA K MATTHEWS
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Credential | RN
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Telephone | 314-450-0005
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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 | IL
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