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General NPI Number Information
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NPI Number | 1548426463
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Entity Type | Organization
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Legal Business Name | ZION LLC
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Dates
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Enumeration Date | 07/30/2008
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 2403 STEWART AVE
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City | SAINT PAUL
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State | MN
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Zip | 55116-3036
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Country | US
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Telephone | 612-481-6001
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Fax | 651-698-9466
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Provider Business Mailing Address
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Address Line | 2403 STEWART AVE
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City | SAINT PAUL
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State | MN
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Zip | 55116-3036
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Country | US
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Telephone | 612-481-6005
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Fax | 651-698-9466
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. VALLANTINE EBOT ATEM
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Credential |
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Telephone | 612-481-6005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | L061734-1
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | R183439-8
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License Number State | MN
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