- Enrollment id
- O20071114000553
- Enrollment state
- MA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1063691905
- Multiple npi flag
- N
- Ccn
- 227507
- Associate id
- 0042308603
- Organization name
- GREATER BOSTON HOME HEALTH CARE, LLC
- Incorporation date
- 2007-09-05
- Incorporation state
- MA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 661 CENTRE ST
- City
- BROCKTON
- State
- MA
- Zip code
- 02302