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General NPI Number Information
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NPI Number | 1578902250
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Entity Type | Organization
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Legal Business Name | PROMISE CARE, INC
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Dates
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Enumeration Date | 06/17/2013
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Last Update Date | 04/05/2018
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Provider Practice Location Address
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Address Line | 7900 INTERNATIONAL DRIVE SUITE 300
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City | BLOOMINGTON
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State | MN
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Zip | 55425
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Country | US
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Telephone | 952-999-7974
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Fax | 952-674-4527
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Provider Business Mailing Address
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Address Line | 7900 INTERNATIONAL DRIVE SUITE 300
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City | BLOOMINGTON
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State | MN
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Zip | 55425
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Country | US
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Telephone | 952-999-7974
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Fax | 952-674-4527
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Authorized Official
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Title or Position | COO
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Name | MR. MARK JOHN BELLESTRI
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Credential |
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Telephone | 952-999-7974
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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 | 360903
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License Number State | MN
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