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General NPI Number Information
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NPI Number | 1902007255
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Entity Type | Organization
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Legal Business Name | CAPITAL HOME HEALTH AGENCY, INC.
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 07/30/2007
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Provider Practice Location Address
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Address Line | 2818 LA CIENEGA AVE SUITE 205
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City | LOS ANGELES
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State | CA
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Zip | 90034-2618
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Country | US
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Telephone | 310-253-5384
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Fax | 310-253-9191
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Provider Business Mailing Address
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Address Line | 2818 LA CIENEGA AVE SUITE 205
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City | LOS ANGELES
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State | CA
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Zip | 90034-2618
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Country | US
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Telephone | 310-253-5384
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Fax | 310-025-3919
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. LINDEN LELLIS LOGAN
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Credential | R.N.
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Telephone | 310-253-5384
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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 | 980001281
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License Number State | CA
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