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General NPI Number Information
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NPI Number | 1922091651
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Entity Type | Organization
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Legal Business Name | JORDAN HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 08/29/2005
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 3505 SUMMERHILL RD STE 8
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City | TEXARKANA
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State | TX
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Zip | 75503-3596
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Country | US
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Telephone | 903-794-3102
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Fax | 903-793-1875
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Provider Business Mailing Address
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Address Line | 3010 LYNDON B JOHNSON FWY STE 1100
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City | DALLAS
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State | TX
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Zip | 75234-2712
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Country | US
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Telephone | 800-379-1600
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Fax | 903-537-8420
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Authorized Official
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Title or Position | COMPLIANCE PRIVACY&SAFETY OFFICER
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Name | KATIE MONASTIERE
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Credential |
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Telephone | 517-768-4373
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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 | 008181
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License Number State | TX
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