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General NPI Number Information
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NPI Number | 1760782023
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Entity Type | Organization
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Legal Business Name | FAITHFUL SHEPHARD'S HOME CARE , LLC
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Dates
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Enumeration Date | 11/02/2010
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Last Update Date | 12/03/2010
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Provider Practice Location Address
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Address Line | 1390 WALKUP AVE SUITE G
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City | MONROE
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State | NC
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Zip | 28110
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Country | US
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Telephone | 704-296-2545
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Fax |
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Provider Business Mailing Address
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Address Line | 621 E SECOND AVE SUITE 3
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City | GASTONIA
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State | NC
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Zip | 28054
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Country | US
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Telephone | 704-884-5694
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MARIE B LEE
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Credential |
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Telephone | 704-884-5694
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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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