- Enrollment id
- O20231109000214
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1134905284
- Multiple npi flag
- N
- Ccn
- 369382
- Associate id
- 8921453952
- Organization name
- AHC HOME HEALTH OF CLEVELAND LLC
- Incorporation date
- 2023-04-11
- Incorporation state
- UT
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 2108 LANDER RD
- Address line 2
- STE B
- City
- MAYFIELD HEIGHTS
- State
- OH
- Zip code
- 441244152