- Enrollment id
- O20230105002388
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1023615978
- Multiple npi flag
- N
- Ccn
- 369356
- Associate id
- 4981074044
- Organization name
- ALTERNATIVE HOME HEALTH AGENCY LLC
- Incorporation date
- 2022-09-27
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 1395 E DUBLIN GRANVILLE RD
- Address line 2
- STE 418
- City
- COLUMBUS
- State
- OH
- Zip code
- 432293329