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General NPI Number Information
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NPI Number | 1730441247
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Entity Type | Organization
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Legal Business Name | REPRIEVE HOME CARE LLC
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 06/11/2012
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Provider Practice Location Address
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Address Line | 6020 W SUNNYSIDE DR
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City | GLENDALE
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State | AZ
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Zip | 85304-2532
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Country | US
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Telephone | 623-203-3087
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Fax | 623-266-9167
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Provider Business Mailing Address
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Address Line | 6020 W SUNNYSIDE DR
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City | GLENDALE
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State | AZ
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Zip | 85304-2532
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Country | US
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Telephone | 623-203-3087
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Fax | 623-266-9167
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Authorized Official
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Title or Position | OWNER
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Name | MRS. AMY LYNN MACRI
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Credential |
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Telephone | 623-203-3087
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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 | 500006419
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License Number State | AZ
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