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General NPI Number Information
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NPI Number | 1548608227
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Entity Type | Organization
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Legal Business Name | S J AND K HOME CARE, LLC
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Dates
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Enumeration Date | 06/04/2013
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Last Update Date | 06/04/2013
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Provider Practice Location Address
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Address Line | 4601 EXCELSIOR BLVD SUITE 410
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-4960
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Country | US
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Telephone | 952-300-3698
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Fax | 952-838-5137
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Provider Business Mailing Address
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Address Line | 4601 EXCELSIOR BLVD SUITE 410
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-4960
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Country | US
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Telephone | 952-300-3698
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Fax | 952-838-5137
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Authorized Official
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Title or Position | OWNER
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Name | SUSAN E RATHER
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Credential |
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Telephone | 608-441-8620
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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 | 29454
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License Number State | MN
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