- Enrollment id
- O20200605001237
- Enrollment state
- CO
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1093353997
- Multiple npi flag
- N
- Ccn
- 067595
- Associate id
- 0547681165
- Organization name
- ICARE HOME HEALTH AGENCY LLC
- Incorporation date
- 2019-12-06
- Incorporation state
- CO
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 2851 S PARKER RD
- Address line 2
- STE 428
- City
- AURORA
- State
- CO
- Zip code
- 800142802