- Enrollment id
- O20191211001691
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1033674007
- Multiple npi flag
- N
- Ccn
- 369250
- Associate id
- 4981037686
- Organization name
- RAPHA HOME HEALTH CARE, LLC
- Incorporation date
- 2018-11-28
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 2700 E DUBLIN GRANVILLE RD
- Address line 2
- STE 500
- City
- COLUMBUS
- State
- OH
- Zip code
- 432314034