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General NPI Number Information
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NPI Number | 1932395597
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Entity Type | Organization
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Legal Business Name | EAGLE POINTE MANAGEMENT INC
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 09/18/2007
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Provider Practice Location Address
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Address Line | 87 STALEY RD
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City | ORWELL
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State | OH
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Zip | 44076-8377
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Country | US
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Telephone | 440-437-7171
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Fax | 440-437-1086
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Provider Business Mailing Address
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Address Line | 2921 CHAPEL RD
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City | ASHTABULA
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State | OH
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Zip | 44004-9531
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Country | US
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Telephone | 440-812-1244
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOYCE M HUMPHREY
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Credential | LNHA, RN
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Telephone | 440-812-1244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 1748N
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License Number State | OH
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