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General NPI Number Information
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NPI Number | 1780180422
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Entity Type | Organization
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Legal Business Name | PERFECTED HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 04/02/2018
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Last Update Date | 04/02/2018
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Provider Practice Location Address
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Address Line | 5580 HIGHWAY 557 STE 101K
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City | LAKE WYLIE
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State | SC
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Zip | 29710-7359
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Country | US
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Telephone | 803-831-6013
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Fax | 803-831-6012
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Provider Business Mailing Address
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Address Line | 1205 HORSESUGAR RD
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City | CLOVER
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State | SC
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Zip | 29710-8872
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Country | US
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Telephone | 832-233-1726
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LATONYA N RAIFORD
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Credential |
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Telephone | 832-233-1726
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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 | IHCP-0809
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License Number State | SC
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