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General NPI Number Information
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NPI Number | 1619791928
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Entity Type | Organization
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Legal Business Name | ANGEL CARE ASSISTED LIVING LLC
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 2227 BLOOMINGTON AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55404-3039
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Country | US
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Telephone | 619-808-6167
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Fax | 612-500-4790
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Provider Business Mailing Address
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Address Line | 2227 BLOOMINGTON AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55404-3039
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Country | US
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Telephone | 619-808-6167
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Fax | 612-500-4790
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Authorized Official
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Title or Position | OWNER
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Name | ZAMZAM ABDI
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Credential |
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Telephone | 619-808-6167
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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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