- Enrollment id
- O20140820000048
- Enrollment state
- PR
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1437563418
- Multiple npi flag
- N
- Ccn
- 407024
- Associate id
- 1557589363
- Organization name
- METRO PAVIA AT HOME, LLC
- Doing business as name
- METRO PAVIA @ HOME
- Incorporation date
- 2014-03-28
- Incorporation state
- PR
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 153 AVE JOSE DE DIEGO
- Address line 2
- STE 205
- City
- ARECIBO
- State
- PR
- Zip code
- 006124779