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General NPI Number Information
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NPI Number | 1851699813
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Entity Type | Organization
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Legal Business Name | EMANNUEL CARE HOME HEALTH AGENCY, LLC
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Dates
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Enumeration Date | 03/01/2011
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 22245 MAIN ST SUITE# 104
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City | HAYWARD
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State | CA
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Zip | 94541-4028
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Country | US
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Telephone | 510-885-1926
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Fax | 510-886-8418
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Provider Business Mailing Address
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Address Line | 22245 MAIN ST SUITE# 104
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City | HAYWARD
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State | CA
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Zip | 94541-4028
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Country | US
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Telephone | 510-885-1926
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Fax | 510-886-8418
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Authorized Official
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Title or Position | MEMBER/ADMINISTRATOR
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Name | MS. MILIAKERE TAWAKE
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Credential |
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Telephone | 510-885-1926
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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 | 550001874
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License Number State | CA
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