- Enrollment id
- O20251023000710
- Enrollment state
- WY
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1083597769
- Multiple npi flag
- N
- Ccn
- 537085
- Associate id
- 9537657390
- Organization name
- STEAMBOAT HEALTHCARE LLC
- Doing business as name
- HEALING HEARTS HOME HEALTH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 902 E 3RD ST
- City
- GILLETTE
- State
- WY
- Zip code
- 827164023