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NPI 1548975113

NPI 1548975113 : ALL DUNN ASSISTANT LIVING FACILITY #2 : PEMBROKE PINES, FL

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General NPI Number Information
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    NPI Number           |    1548975113
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    Entity Type          |    Organization 
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    Legal Business Name  |    ALL DUNN ASSISTANT LIVING FACILITY #2 
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Dates
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    Enumeration Date     |    01/18/2023
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    Last Update Date     |    01/18/2023
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Provider Practice Location Address
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    Address Line         |    9920 NW 3RD ST 
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    City                 |    PEMBROKE PINES
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    State                |    FL
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    Zip                  |    33024-6146
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    Country              |    US
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    Telephone            |    954-806-7951
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9920 NW 3RD ST 
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    City                 |    PEMBROKE PINES
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    State                |    FL
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    Zip                  |    33024-6146
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    ADMINISTRATOR
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    Name                 |     DAVE  DUNN 
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    Credential           |    
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    Telephone            |    954-806-7951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    3104A0630X
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    Taxonomy Name        |    Assisted Living Facility (Behavioral Disturbances)
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    310400000X
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    Taxonomy Name        |    Assisted Living Facility
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    License Number       |    
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    License Number State |    
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