- Enrollment id
- O20221128001588
- Enrollment state
- NV
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1013668490
- Multiple npi flag
- N
- Ccn
- 297360
- Associate id
- 9931580123
- Organization name
- GENTLE HEARTS HOME HEALTH INC
- Incorporation date
- 2020-08-19
- Incorporation state
- NV
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 3017 W CHARLESTON BLVD
- Address line 2
- STE 51-B
- City
- LAS VEGAS
- State
- NV
- Zip code
- 89102