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General NPI Number Information
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NPI Number | 1528249869
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Entity Type | Organization
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Legal Business Name | CITY HOME CARE, LLC
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 01/25/2010
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Provider Practice Location Address
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Address Line | 3324 GOODMAN RD E
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City | SOUTHAVEN
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State | MS
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Zip | 38672-6433
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Country | US
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Telephone | 601-213-4893
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Fax | 901-744-7583
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Provider Business Mailing Address
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Address Line | 3324 GOODMAN RD E
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City | SOUTHAVEN
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State | MS
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Zip | 38672-6433
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Country | US
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Telephone | 601-213-4893
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Fax | 901-744-7583
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. CHERRYL EVONNE JONES
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Credential |
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Telephone | 601-213-4893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 2330
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License Number State | MS
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