- Enrollment id
- O20050602000177
- Enrollment state
- MS
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1235270588
- Multiple npi flag
- N
- Ccn
- 257131
- Associate id
- 7810930732
- Organization name
- STA-HOME HEALTH AGENCY OF GREENWOOD, INC.
- Doing business as name
- ACCENTCARE HOME HEALTH OF GREENWOOD
- Incorporation date
- 1997-07-01
- Incorporation state
- MS
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 205 WALTHALL ST
- City
- GREENWOOD
- State
- MS
- Zip code
- 389304428