- Enrollment id
- O20221014002637
- Enrollment state
- UT
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1144223249
- Multiple npi flag
- N
- Ccn
- 467110
- Associate id
- 9537535596
- Organization name
- SPECIALTY NURSING SERVICES
- Doing business as name
- SPECIALTY NURSING SERVICES
- Incorporation date
- 2022-06-08
- Incorporation state
- UT
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 620 S 9500 E
- City
- HUNTSVILLE
- State
- UT
- Zip code
- 843179748