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General NPI Number Information
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NPI Number | 1598983074
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Entity Type | Organization
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Legal Business Name | THERAPY 2000
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2535 LONE STAR DR
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City | DALLAS
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State | TX
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Zip | 75212-6313
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Country | US
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Telephone | 214-467-9787
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Fax |
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Provider Business Mailing Address
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Address Line | 831 LONGHORN HOLW
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City | SOUTHLAKE
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State | TX
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Zip | 76092-8353
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Country | US
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Telephone | 817-749-2119
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JERRE VAN DEN BENT
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Credential | P.T
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Telephone | 214-467-9787
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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 | 19554
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License Number State | TX
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