- Enrollment id
- O20090408000204
- Enrollment state
- FL
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1427224666
- Multiple npi flag
- N
- Ccn
- 109502
- Associate id
- 0840347803
- Organization name
- AGING PARADISE, INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1620 W. OAKLAND PARK BLVD.
- Address line 2
- STE. 203
- City
- OAKLAND PARK
- State
- FL
- Zip code
- 333111506
- Practice location type
- HHA BRANCH