- Enrollment id
- O20150527000579
- Enrollment state
- FL
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1346640992
- Multiple npi flag
- N
- Ccn
- 683194
- Associate id
- 1052631439
- Organization name
- ETHIC HEALTH SERVICES, LLC
- Incorporation date
- 2014-07-28
- Incorporation state
- FL
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 13574 VILLAGE PARK DR
- Address line 2
- STE 220
- City
- ORLANDO
- State
- FL
- Zip code
- 328377694