- Enrollment id
- O20080104000333
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1386849008
- Multiple npi flag
- N
- Ccn
- 367167
- Associate id
- 2163502063
- Organization name
- AMERICAN MERCY HOME CARE LLC
- Incorporation date
- 2007-06-13
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 4000 SMITH RD
- Address line 2
- STE 200
- City
- CINCINNATI
- State
- OH
- Zip code
- 452091967