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General NPI Number Information
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NPI Number | 1770537110
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Entity Type | Organization
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Legal Business Name | IR HOME HEALTH
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 1805 FLORENCE RD SUITE 14
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City | KILLEEN
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State | TX
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Zip | 76541-8523
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Country | US
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Telephone | 254-628-7900
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Fax | 254-628-7905
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Provider Business Mailing Address
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Address Line | PO BOX 2910
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City | HARKER HEIGHTS
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State | TX
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Zip | 76548-0910
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Country | US
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Telephone | 254-628-7900
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Fax | 254-628-7905
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Authorized Official
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Title or Position | CFO
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Name | MRS. KIDADA AKILAH MITCHELL
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Credential | OTR/L
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Telephone | 254-628-7900
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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 | 009276
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License Number State | TX
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