- Enrollment id
- O20051202000773
- Enrollment state
- MI
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1063635191
- Multiple npi flag
- N
- Ccn
- 237652
- Associate id
- 7719907856
- Organization name
- OPTIMUM PLUS HOME CARE LLC
- Incorporation date
- 2005-03-28
- Incorporation state
- MI
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 29610 SOUTHFIELD RD
- Address line 2
- STE 260
- City
- SOUTHFIELD
- State
- MI
- Zip code
- 480762000