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General NPI Number Information
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NPI Number | 1699226019
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Entity Type | Organization
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Legal Business Name | BAYGROUP HEALTHCARE NORTHWEST
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Dates
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Enumeration Date | 10/20/2016
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Last Update Date | 10/20/2016
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Provider Practice Location Address
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Address Line | 138 S MAIN ST
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City | CROWN POINT
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State | IN
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Zip | 46307-4086
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Country | US
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Telephone | 708-214-2579
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Fax |
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Provider Business Mailing Address
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Address Line | 8569 DOUBLETREE DR N
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City | CROWN POINT
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State | IN
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Zip | 46307-9805
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSISTANT ADMINISTRATOR
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Name | MRS. KATHRINA B NINH
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Credential |
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Telephone | 708-214-2579
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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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