- Enrollment id
- O20210108000097
- Enrollment state
- NY
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1114557931
- Multiple npi flag
- N
- Ccn
- 337441
- Associate id
- 4183037310
- Organization name
- PROSPECT ACQUISITION III LLC
- Doing business as name
- CASSENA CARE AT HOME
- Incorporation date
- 2017-01-20
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 1000 GATES AVE
- City
- BROOKLYN
- State
- NY
- Zip code
- 112216295