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General NPI Number Information
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NPI Number | 1811162902
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Entity Type | Organization
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Legal Business Name | ASSURED HOME CARE, LLC
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 02/26/2012
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Provider Practice Location Address
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Address Line | 4875 PALM COAST PKWY NW SUITE #4
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City | PALM COAST
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State | FL
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Zip | 32137-3670
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Country | US
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Telephone | 386-597-5754
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Fax | 386-597-5724
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Provider Business Mailing Address
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Address Line | PO BOX 352342
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City | PALM COAST
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State | FL
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Zip | 32135-2342
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Country | US
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Telephone | 386-597-5754
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Fax | 386-597-5724
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SYLVESTER WILLIAMS
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Credential |
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Telephone | 386-597-5754
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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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