- Enrollment id
- O20200511003365
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1316570799
- Multiple npi flag
- N
- Ccn
- 369245
- Associate id
- 3577994367
- Organization name
- EXCELLENT COMMUNITY HOME HEALTHCARE, LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 2999 E DUBLIN GRANVILLE RD
- Address line 2
- STE 100
- City
- COLUMBUS
- State
- OH
- Zip code
- 432314084