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General NPI Number Information
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NPI Number | 1639236888
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Entity Type | Organization
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Legal Business Name | REST HAVEN HOME HEALTH, INC.
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 01/17/2012
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Provider Practice Location Address
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Address Line | 520 WILLIS AVENUE
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City | BOGALUSA
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State | LA
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Zip | 70429-0650
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Country | US
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Telephone | 985-732-4892
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Fax | 985-732-1878
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Provider Business Mailing Address
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Address Line | PO BOX 650 520 WILLIS AVENUE
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City | BOGALUSA
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State | LA
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Zip | 70429-0650
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Country | US
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Telephone | 985-732-4892
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Fax | 985-732-1878
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Authorized Official
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Title or Position | CFO CHIEF EXECUTIVE OFFICIAL CHIEF
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Name | MICHAEL DENNIS HEMPHILL
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Credential |
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Telephone | 985-732-4892
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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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