- Enrollment id
- O20060330000198
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1225009442
- Multiple npi flag
- N
- Ccn
- 367142
- Associate id
- 3375455892
- Organization name
- CLEVELAND CLINIC FOUNDATION CLEVELAND CLINIC HOME CARE
- Incorporation date
- 1984-01-12
- Incorporation state
- OH
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 6801 BRECKSVILLE RD
- Address line 2
- STE 10
- City
- INDEPENDENCE
- State
- OH
- Zip code
- 441315057