- Enrollment id
- O20071121000486
- Enrollment state
- MA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1104937697
- Multiple npi flag
- N
- Ccn
- 227101
- Associate id
- 5193637189
- Organization name
- SOUTHCOAST VISITING NURSE ASSOCIATION, INC
- Incorporation date
- 1925-01-01
- Incorporation state
- MA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 200 MILL ROAD
- City
- FAIRHAVEN
- State
- MA
- Zip code
- 027195252
- Practice location type
- HHA BRANCH