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General NPI Number Information
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NPI Number | 1558683961
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Entity Type | Organization
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Legal Business Name | REHABCARE GROUP
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Dates
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Enumeration Date | 02/26/2010
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Last Update Date | 02/26/2010
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Provider Practice Location Address
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Address Line | 118 ROGER DR
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City | COLLINSVILLE
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State | IL
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Zip | 62234-5814
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Country | US
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Telephone | 618-791-3923
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Fax |
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Provider Business Mailing Address
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Address Line | 118 ROGER DR
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City | COLLINSVILLE
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State | IL
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Zip | 62234-5814
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Country | US
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Telephone | 618-791-3923
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MRS. JACQUELINE D STROUD
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Credential | OT/L
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Telephone | 618-791-3923
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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 | 056006684
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License Number State | IL
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