- Enrollment id
- O20180503000277
- Enrollment state
- KS
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1407352867
- Multiple npi flag
- N
- Ccn
- 178124
- Associate id
- 6507120326
- Organization name
- INFINITY HOME HEALTH LLC
- Incorporation date
- 2017-01-05
- Incorporation state
- KS
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 7230 W 13TH ST N
- Address line 2
- STE 4
- City
- WICHITA
- State
- KS
- Zip code
- 672122982