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General NPI Number Information
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NPI Number | 1629288618
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Entity Type | Organization
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Legal Business Name | CAREAGE HOME HEALTH LLC
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 02/27/2014
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Provider Practice Location Address
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Address Line | 14450 NE 29TH PL SUITE 106
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City | BELLEVUE
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State | WA
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Zip | 98007-8616
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Country | US
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Telephone | 425-519-1265
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Fax | 425-861-7879
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Provider Business Mailing Address
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Address Line | PO BOX 1969
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City | GIG HARBOR
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State | WA
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Zip | 98335-3969
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Country | US
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Telephone | 253-853-4457
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Fax | 253-853-5280
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Authorized Official
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Title or Position | CEO
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Name | MR. KELLY L CALLAHAN
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Credential |
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Telephone | 253-853-4457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | IHS.FS.60007888
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License Number State | WA
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