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General NPI Number Information
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NPI Number | 1821348798
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Entity Type | Organization
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Legal Business Name | RESIDENT AIDES LLC
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 93 HILLSIDE AVE
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City | NEWARK
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State | NJ
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Zip | 07108-2811
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Country | US
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Telephone | 908-931-0109
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Fax | 908-931-0109
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Provider Business Mailing Address
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Address Line | 16 SOUTH AVE W SUITE 234
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City | CRANFORD
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State | NJ
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Zip | 07016-2695
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Country | US
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Telephone | 908-931-0109
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Fax | 908-931-0109
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CARLTON L BROWN
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Credential |
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Telephone | 908-931-0109
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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 | HP015900
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License Number State | NJ
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