- Enrollment id
- O20200206002898
- Enrollment state
- CT
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1376105767
- Multiple npi flag
- N
- Ccn
- 077277
- Associate id
- 4284060492
- Organization name
- MCANGEL HOME VISITING NURSES LLC
- Incorporation date
- 2017-12-14
- Incorporation state
- CT
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 60 WASHINGTON AVE
- Address line 2
- STE 105
- City
- HAMDEN
- State
- CT
- Zip code
- 065183272
- Practice location type
- HHA BRANCH