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General NPI Number Information
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NPI Number | 1700871233
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Entity Type | Organization
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Legal Business Name | INTRA CARE HOME HEALTH PROVIDERS INC
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 11/07/2018
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Provider Practice Location Address
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Address Line | 4929 WILSHIRE BLVD SUITE 210
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City | LOS ANGELES
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State | CA
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Zip | 90010-3808
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Country | US
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Telephone | 323-964-0884
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Fax | 323-857-7206
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Provider Business Mailing Address
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Address Line | 4929 WILSHIRE BLVD SUITE 210
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City | LOS ANGELES
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State | CA
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Zip | 90010-3808
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Country | US
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Telephone | 323-964-0884
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Fax | 323-857-7206
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. DIONALYN UGBEBOR
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Credential | RN,BSN
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Telephone | 323-964-0884
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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 | 980001387
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License Number State | CA
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