Public record

CMS Home Health Agency Enrollments

Npi: 1114971280 · 1 matching record

Enrollment id
O20040806000955
Enrollment state
CA
Provider type code
00-06
Provider type text
PART A PROVIDER - HOME HEALTH AGENCY
Npi
1114971280
Multiple npi flag
N
Ccn
557194
Associate id
2365414885
Organization name
TENDER LOVING CARE HEALTH CARE SERVICES WESTERN, LLC
Doing business as name
AMEDISYS HOME HEALTH CARE
Incorporation date
2004-04-07
Incorporation state
CA
Organization type structure
LLC
Proprietary nonprofit
P
Address line 1
24301 SOUTHLAND DR
Address line 2
STE 411
City
HAYWARD
State
CA
Zip code
945451551

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