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General NPI Number Information
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NPI Number | 1912498783
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Entity Type | Organization
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Legal Business Name | RAYS OF LIGHT COMPANION CARE AGENCY LLC
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Dates
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Enumeration Date | 05/28/2018
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Last Update Date | 05/28/2018
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Provider Practice Location Address
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Address Line | 70 FOREST AVE # 2G
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City | GLEN COVE
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State | NY
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Zip | 11542
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Country | US
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Telephone | 516-373-5586
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Fax |
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Provider Business Mailing Address
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Address Line | 70 FOREST AVE # 2G
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City | GLEN COVE
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State | NY
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Zip | 11542-2117
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Country | US
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Telephone | 516-373-5586
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YVELISE MARCELLUS
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Credential |
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Telephone | 516-373-5586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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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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