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General NPI Number Information
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NPI Number | 1518323724
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Entity Type | Organization
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Legal Business Name | ASSURANCE HEALTHCARE SERVICES, LLC
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Dates
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Enumeration Date | 01/05/2016
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Last Update Date | 01/05/2016
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Provider Practice Location Address
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Address Line | 4420 STARK PL
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City | ANNANDALE
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State | VA
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Zip | 22003-3960
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Country | US
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Telephone | 240-498-1461
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Fax | 301-398-8312
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Provider Business Mailing Address
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Address Line | 4420 STARK PL
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City | ANNANDALE
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State | VA
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Zip | 22003-3960
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Country | US
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Telephone | 240-498-1461
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Fax | 301-398-8312
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Authorized Official
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Title or Position | CEO
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Name | DR. PETER FRU AKUFONGWE
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Credential |
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Telephone | 240-498-1461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 2464
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License Number State | VA
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