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General NPI Number Information
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NPI Number | 1649806084
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Entity Type | Organization
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Legal Business Name | BESTACARE LLC
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Dates
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Enumeration Date | 03/17/2020
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 1409 WASHINGTON AVE STE 207
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City | SAINT LOUIS
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State | MO
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Zip | 63103-1936
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Country | US
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Telephone | 314-252-0522
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Fax | 314-682-4127
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Provider Business Mailing Address
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Address Line | 1409 WASHINGTON AVE STE 207
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City | SAINT LOUIS
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State | MO
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Zip | 63103-1936
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Country | US
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Telephone | 314-252-0522
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Fax | 314-287-5690
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ASHLEY NICOLE JACKSON
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Credential |
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Telephone | 314-477-0694
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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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