- Enrollment id
- O20150529000376
- Enrollment state
- NY
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1235529538
- Multiple npi flag
- N
- Ccn
- 337189
- Associate id
- 5395065544
- Organization name
- ROYAL CARE CERTIFIED HOME HEALTH CARE LLC
- Doing business as name
- EMEREST HOME HEALTH CARE OF LONG ISLAND
- Incorporation date
- 2014-02-25
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 3050 WHITESTONE EXPY
- Address line 2
- STE 304
- City
- FLUSHING
- State
- NY
- Zip code
- 113541995