- Enrollment id
- O20080820000165
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1184881666
- Multiple npi flag
- N
- Ccn
- 368243
- Associate id
- 3678648086
- Organization name
- FULL-CARE HOME HEALTH LLC
- Incorporation date
- 2007-04-17
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 1395 E DUBLIN GRANVILLE RD
- Address line 2
- STE 400
- City
- COLUMBUS
- State
- OH
- Zip code
- 43229