- Enrollment id
- O20240227003146
- Enrollment state
- IL
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1114709987
- Multiple npi flag
- N
- Ccn
- 148423
- Associate id
- 9133564305
- Organization name
- MERITCARE HOME HEALTH INC
- Incorporation date
- 2005-04-21
- Incorporation state
- IL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5940 W TOUHY AVE
- Address line 2
- STE 185 A
- City
- NILES
- State
- IL
- Zip code
- 607144642