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General NPI Number Information
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NPI Number | 1669045670
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Entity Type | Organization
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Legal Business Name | COMPLETE HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 07/19/2021
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 3607 RAFTERSRIDGE DR
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City | MIDLOTHIAN
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State | VA
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Zip | 23113-3747
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Country | US
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Telephone | 516-459-9288
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Fax |
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Provider Business Mailing Address
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Address Line | 3607 RAFTERSRIDGE DR
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City | MIDLOTHIAN
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State | VA
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Zip | 23113-3747
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Country | US
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Telephone | 516-459-9288
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SAMUEL JAMES LONGO
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Credential | DPT
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Telephone | 516-459-9288
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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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