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NPI 1720803307

NPI 1720803307 : AMARA BEHAVIORAL HEALTH LLC : WRENTHAM, MA

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General NPI Number Information
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    NPI Number           |    1720803307
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    Entity Type          |    Organization 
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    Legal Business Name  |    AMARA BEHAVIORAL HEALTH LLC 
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Dates
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    Enumeration Date     |    11/19/2024
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    Last Update Date     |    11/29/2024
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Provider Practice Location Address
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    Address Line         |    895 FRANKLIN ST 
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    City                 |    WRENTHAM
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    State                |    MA
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    Zip                  |    02093-1232
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    Country              |    US
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    Telephone            |    917-207-7197
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    Fax                  |    617-977-8978
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Provider Business Mailing Address
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    Address Line         |    82 WENDELL AVE STE 100 
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    City                 |    PITTSFIELD
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    State                |    MA
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    Zip                  |    01201-7066
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    Country              |    US
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    Telephone            |    917-207-7197
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    Fax                  |    617-977-8978
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     UCHE  OBU 
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    Credential           |    
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    Telephone            |    617-207-7197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    
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    License Number State |    
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