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NPI 1598547036

NPI 1598547036 : HOPE AND AMAZING COMFORT CARE LLC : PORT SAINT LUCIE, FL

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General NPI Number Information
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    NPI Number           |    1598547036
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    Entity Type          |    Organization 
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    Legal Business Name  |    HOPE AND AMAZING COMFORT CARE LLC 
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Dates
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    Enumeration Date     |    10/18/2023
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    Last Update Date     |    11/29/2023
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Provider Practice Location Address
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    Address Line         |    1860 SW FOUNTAINVIEW BLVD 
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    City                 |    PORT SAINT LUCIE
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    State                |    FL
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    Zip                  |    34986-4535
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    Country              |    US
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    Telephone            |    772-301-9461
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1860 SW FOUNTAINVIEW BLVD STE 100 
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    City                 |    PORT SAINT LUCIE
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    State                |    FL
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    Zip                  |    34986-4528
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    Country              |    US
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    Telephone            |    772-301-9461
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     OMAMEZI  OLOKOR 
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    Credential           |    
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    Telephone            |    772-301-9461
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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       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    251J00000X
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    Taxonomy Name        |    Nursing Care Agency
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    253Z00000X
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    Taxonomy Name        |    In Home Supportive Care Agency
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    License Number       |    
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    License Number State |    
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