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General NPI Number Information
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NPI Number | 1649600289
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Entity Type | Organization
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Legal Business Name | UNI
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Dates
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Enumeration Date | 11/18/2013
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Last Update Date | 11/18/2013
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Provider Practice Location Address
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Address Line | 1711 HORIZON HEIGHTS CIR
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City | EL CAJON
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State | CA
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Zip | 92019-1159
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Country | US
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Telephone | 516-993-7775
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Fax |
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Provider Business Mailing Address
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Address Line | 1711 HORIZON HEIGHTS CIR
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City | EL CAJON
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State | CA
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Zip | 92019-1159
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Country | US
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Telephone | 516-993-7775
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Fax |
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Authorized Official
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Title or Position | RN
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Name | MISS MARIA ANN THARAKAN
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Credential | NURSE
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Telephone | 516-993-7775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number | 798212
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License Number State | CA
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