- Enrollment id
- O20090602000331
- Enrollment state
- IL
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1376783936
- Multiple npi flag
- N
- Ccn
- 148203
- Associate id
- 0941350540
- Organization name
- AL-SHAFA HEALTH CARE, INC.
- Doing business as name
- 1ST UNITED HOME HEALTH CARE, INC.
- Incorporation date
- 2006-03-21
- Incorporation state
- IL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 8150 W 111TH ST
- Address line 2
- STE 9
- City
- PALOS HILLS
- State
- IL
- Zip code
- 604652592