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General NPI Number Information
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NPI Number | 1902261027
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Entity Type | Organization
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Legal Business Name | VETERANS HEALTHCARE SYSTEM
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Dates
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Enumeration Date | 12/16/2015
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Last Update Date | 12/16/2015
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Provider Practice Location Address
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Address Line | 2215 FULLER RD
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City | ANN ARBOR
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State | MI
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Zip | 48105-2303
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Country | US
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Telephone | 734-222-7476
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Fax |
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Provider Business Mailing Address
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Address Line | 320 E CLARK RD
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City | YPSILANTI
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State | MI
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Zip | 48198-3665
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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 | CLINICAL SOCIAL WORKER
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Name | KAYLEN RAE BOROFF
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Credential | LCSW, LCAS
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Telephone | 734-222-7476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 16062
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | C009254
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License Number State | NC
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