- Enrollment id
- O20040722000079
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1235127838
- Multiple npi flag
- N
- Ccn
- 367160
- Associate id
- 3971583816
- Organization name
- FIDELITY HEALTH CARE INC
- Doing business as name
- FIDELITY NURSING SYSTEMS
- Incorporation date
- 1992-08-01
- Incorporation state
- OH
- Organization type structure
- OTHER
- Organization other type text
- NON-PROFIT
- Proprietary nonprofit
- N
- Address line 1
- 3170 KETTERING BLVD
- City
- MORAINE
- State
- OH
- Zip code
- 454391924