- Enrollment id
- O20120627000015
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1073828422
- Multiple npi flag
- N
- Ccn
- 368467
- Associate id
- 0648435529
- Organization name
- SENIOR HOMECARE UNLIMITED, LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 100 LIMING FARM RD
- City
- MOUNT ORAB
- State
- OH
- Zip code
- 451548944