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General NPI Number Information
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NPI Number | 1578376000
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Entity Type | Organization
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Legal Business Name | TRIPLE B HOME CARE LLC
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 7025 QUAIL AVE N
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City | BROOKLYN CENTER
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State | MN
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Zip | 55429-1228
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Country | US
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Telephone | 763-447-1062
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Fax |
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Provider Business Mailing Address
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Address Line | 7025 QUAIL AVE N
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City | BROOKLYN CENTER
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State | MN
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Zip | 55429-1228
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Country | US
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Telephone | 763-447-1062
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Fax |
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Authorized Official
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Title or Position | DON
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Name | MOTUNRAYO FANIYI
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Credential | RN
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Telephone | 763-447-1062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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