- Enrollment id
- O20170502002815
- Enrollment state
- NV
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1124568464
- Multiple npi flag
- N
- Ccn
- 297246
- Associate id
- 0941587877
- Organization name
- ALPINE HOME HEALTH, INC
- Incorporation date
- 2015-07-24
- Incorporation state
- NV
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 3017 W CHARLESTON BLVD
- Address line 2
- STE 51-A
- City
- LAS VEGAS
- State
- NV
- Zip code
- 891021941