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General NPI Number Information
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NPI Number | 1518271311
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Entity Type | Organization
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Legal Business Name | MAGDALENE CARE LLC
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 08/04/2010
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Provider Practice Location Address
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Address Line | 3608 S BURDICK ST
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City | KALAMAZOO
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State | MI
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Zip | 49001-4838
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Country | US
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Telephone | 269-366-4422
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Fax | 269-366-4429
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Provider Business Mailing Address
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Address Line | 3608 S BURDICK ST
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City | KALAMAZOO
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State | MI
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Zip | 49001-4838
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Country | US
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Telephone | 269-366-4422
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Fax | 269-366-4429
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. PAMELA DODD JONES
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Credential | R.N.
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Telephone | 269-908-1950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 4704257013
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License Number State | MI
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