- Enrollment id
- O20090908000561
- Enrollment state
- FL
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1174764880
- Multiple npi flag
- N
- Ccn
- 109663
- Associate id
- 1355496704
- Organization name
- FOREVER HOME HEALTH CARE, INC.
- Incorporation date
- 2009-01-28
- Incorporation state
- FL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 8249 NW 36TH ST
- Address line 2
- STE 117
- City
- DORAL
- State
- FL
- Zip code
- 331666673