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General NPI Number Information
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NPI Number | 1710030432
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Entity Type | Organization
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Legal Business Name | DETERMINED HOME CARE AGENCY LLC
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 301 S CHURCH ST SUITE 144
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-5755
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Country | US
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Telephone | 252-454-0404
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Fax | 252-454-0405
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Provider Business Mailing Address
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Address Line | 301 S CHURCH ST SUITE 144
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-5755
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Country | US
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Telephone | 252-454-0404
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Fax | 252-454-0405
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. TERRY HARRIS
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Credential |
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Telephone | 252-281-4838
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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 | HC3103
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License Number State | NC
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