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General NPI Number Information
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NPI Number | 1629790118
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Entity Type | Organization
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Legal Business Name | MANNA HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 09/13/2022
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 2013 LIVE OAK BLVD STE F
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City | SAINT CLOUD
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State | FL
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Zip | 34771-8410
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Country | US
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Telephone | 407-556-5264
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Fax | 407-593-6560
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Provider Business Mailing Address
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Address Line | 2013 LIVE OAK BLVD STE F
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City | SAINT CLOUD
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State | FL
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Zip | 34771-8410
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Country | US
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Telephone | 407-556-5264
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Fax | 407-593-6560
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Authorized Official
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Title or Position | PRESIDENT/ADMINISTRATOR
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Name | DIANA BEAPOT
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Credential |
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Telephone | 407-556-5264
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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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