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General NPI Number Information
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NPI Number | 1922072909
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Entity Type | Organization
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Legal Business Name | HIGH DESERT THERAPY ASSOCIATES INC
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 51681 HUNTINGTON ROAD
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City | LA PINE
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State | OR
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Zip | 97739
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Country | US
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Telephone | 541-536-7399
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Fax | 541-536-6123
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Provider Business Mailing Address
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Address Line | PO BOX 1888
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City | LA PINE
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State | OR
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Zip | 97739
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Country | US
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Telephone | 541-536-7399
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Fax | 541-536-6123
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Authorized Official
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Title or Position | TREASURER EXECUTIVE DIRECTOR
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Name | JAMES PHILIP SMITH
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Credential |
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Telephone | 541-536-7399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 1997001
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License Number State | OR
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