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General NPI Number Information
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NPI Number | 1619403656
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Entity Type | Organization
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Legal Business Name | PRO-STARS HEALTH CARE LLC
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 02/23/2023
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Provider Practice Location Address
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Address Line | 980 9TH ST FL 16
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City | SACRAMENTO
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State | CA
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Zip | 95814-2736
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Country | US
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Telephone | 916-758-8006
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Fax |
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Provider Business Mailing Address
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Address Line | 9401 E STOCKTON BLVD STE 145
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City | ELK GROVE
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State | CA
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Zip | 95624-5049
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | IJEOMA IHEKE
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Credential |
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Telephone | 916-758-8006
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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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