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General NPI Number Information
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NPI Number | 1639636764
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Entity Type | Organization
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Legal Business Name | RESILIENT CARE ASSISTED LIVING FACILITY
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Dates
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Enumeration Date | 02/25/2019
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Last Update Date | 02/25/2019
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Provider Practice Location Address
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Address Line | 10807 MAIDEN DR
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City | BOWIE
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State | MD
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Zip | 20720-3547
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Country | US
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Telephone | 202-607-7085
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Fax |
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Provider Business Mailing Address
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Address Line | 14320 W SIDE BLVD APT 304
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City | LAUREL
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State | MD
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Zip | 20707-6260
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Country | US
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Telephone | 202-607-7085
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Fax |
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Authorized Official
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Title or Position | ASSISTED LIVING MANAGER
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Name | MRS. UZOAMAKA VICTORIA OKORIE
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Credential | RN
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Telephone | 202-607-7085
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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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