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General NPI Number Information
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NPI Number | 1669770087
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Entity Type | Organization
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Legal Business Name | HOME HEALTHCARE/CPR SERVICES
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Dates
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Enumeration Date | 03/09/2011
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Last Update Date | 03/10/2011
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Provider Practice Location Address
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Address Line | 805 MOUNTAIN OAKS PKWY
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-4744
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Country | US
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Telephone | 678-571-7890
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Fax | 678-580-0462
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Provider Business Mailing Address
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Address Line | PO BOX 870984
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-0025
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Country | US
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Telephone | 678-571-7890
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Fax | 678-580-0462
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Authorized Official
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Title or Position | CEO
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Name | ILA RENEE REESE
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Credential |
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Telephone | 678-571-7890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | RN070868
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License Number State | GA
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