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General NPI Number Information
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NPI Number | 1922773316
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Entity Type | Organization
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Legal Business Name | BRIDGEPORT HOMEHEALTH
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Dates
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Enumeration Date | 08/09/2021
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 27936 LOST CANYON RD STE 205
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City | SANTA CLARITA
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State | CA
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Zip | 91387-3219
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Country | US
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Telephone | 661-309-4858
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Fax | 661-554-8842
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Provider Business Mailing Address
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Address Line | 27936 LOST CANYON RD STE 205
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City | SANTA CLARITA
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State | CA
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Zip | 91387-3219
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Country | US
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Telephone | 661-309-4858
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Fax | 661-554-8842
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Authorized Official
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Title or Position | CFO
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Name | IGNACIO GREGORIO LEVISTE
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Credential |
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Telephone | 818-653-1171
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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 |
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License Number State |
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