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General NPI Number Information
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NPI Number | 1649405945
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Entity Type | Organization
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Legal Business Name | DEFAIT HOME CARE SERVICES
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Dates
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Enumeration Date | 05/16/2009
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Last Update Date | 05/16/2009
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Provider Practice Location Address
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Address Line | 3300 W ROSECRANS AVE SUITE 204
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City | HAWTHORNE
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State | CA
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Zip | 90250-8218
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Country | US
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Telephone | 310-644-4499
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Fax | 310-327-2881
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Provider Business Mailing Address
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Address Line | 3300 W ROSECRANS AVE SUITE 204
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City | HAWTHORNE
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State | CA
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Zip | 90250-8218
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Country | US
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Telephone | 310-644-4499
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Fax | 310-327-2881
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Authorized Official
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Title or Position | SECRETARY
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Name | MRS. ETHEL N. NWANDU
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Credential |
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Telephone | 951-533-8975
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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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