- Enrollment id
- O20050506000776
- Enrollment state
- MP
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1427136464
- Multiple npi flag
- N
- Ccn
- 667001
- Associate id
- 6800836040
- Organization name
- MARIANAS HEALTH SERVICES INC
- Doing business as name
- MHS HOME CARE
- Incorporation date
- 2002-01-21
- Incorporation state
- MP
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- POB 10003 PMB 1341
- Address line 2
- MARIANAS HEALTH LLC BLDG STE201 GHIYEGHI ST. SAN JOSE
- City
- SAIPAN
- State
- MP
- Zip code
- 969508903
- Practice location type
- HHA BRANCH