- Enrollment id
- O20130424000064
- Enrollment state
- CO
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1316257363
- Multiple npi flag
- N
- Ccn
- 067507
- Associate id
- 2860674934
- Organization name
- INFINITI HOME HEALTH CARE AGENCY, LLC
- Doing business as name
- INFINITI HOME HEALTH CARE AGENCY
- Incorporation date
- 2010-06-02
- Incorporation state
- CO
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 1450 S HAVANA ST
- Address line 2
- STE 200B
- City
- AURORA
- State
- CO
- Zip code
- 800124021