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NPI 1972260636

NPI 1972260636 : MIMI CARES PERSONAL CARE : NEWNAN, GA

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General NPI Number Information
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    NPI Number           |    1972260636
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    Entity Type          |    Organization 
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    Legal Business Name  |    MIMI CARES PERSONAL CARE 
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Dates
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    Enumeration Date     |    11/17/2021
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    Last Update Date     |    11/17/2021
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Provider Practice Location Address
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    Address Line         |    34 NEWNAN ESTATES DR APT 34 
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    City                 |    NEWNAN
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    State                |    GA
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    Zip                  |    30263-1138
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    Country              |    US
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    Telephone            |    678-723-8135
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    34 NEWNAN ESTATES DR APT 34 
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    City                 |    NEWNAN
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    State                |    GA
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    Zip                  |    30263-1138
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    Country              |    US
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    Telephone            |    678-723-8135
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER/PROVIDER
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    Name                 |     MIYOSHI  GARRISON 
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    Credential           |    
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    Telephone            |    678-723-8135
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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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