- Enrollment id
- O20080410000035
- Enrollment state
- IL
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1396938783
- Multiple npi flag
- N
- Ccn
- 148034
- Associate id
- 5496832818
- Organization name
- OPTIMUM HOME HEALTH CARE INC
- Incorporation date
- 2006-09-08
- Incorporation state
- IL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 2720 S RIVER RD
- Address line 2
- STE 202
- City
- DES PLAINES
- State
- IL
- Zip code
- 600184111