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NPI 1851155030

NPI 1851155030 : HOME CARE OF VIRTUE LLC : IRON STATION, NC

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General NPI Number Information
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    NPI Number           |    1851155030
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    Entity Type          |    Organization 
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    Legal Business Name  |    HOME CARE OF VIRTUE LLC 
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Dates
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    Enumeration Date     |    02/08/2024
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    Last Update Date     |    02/16/2024
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Provider Practice Location Address
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    Address Line         |    1037 THOROUGHBRED DR 
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    City                 |    IRON STATION
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    State                |    NC
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    Zip                  |    28080-9378
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    Country              |    US
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    Telephone            |    704-666-0297
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1037 THOROUGHBRED DR 
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    City                 |    IRON STATION
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    State                |    NC
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    Zip                  |    28080-9378
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     ALIMOT  AJALA 
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    Credential           |    
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    Telephone            |    704-666-0297
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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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Taxonomy #2
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    Taxonomy Code        |    253Z00000X
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    Taxonomy Name        |    In Home Supportive Care Agency
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    License Number       |    
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    License Number State |    
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