- Enrollment id
- O20130606000632
- Enrollment state
- NY
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1457402505
- Multiple npi flag
- N
- Ccn
- 337136
- Associate id
- 2668463779
- Organization name
- LEWIS COUNTY GENERAL HOSPITAL
- Doing business as name
- LCGH CERTIFIED HOME HEALTH AGENCY
- Incorporation date
- 1931-08-04
- Incorporation state
- NY
- Organization type structure
- GOVERNMENT
- Proprietary nonprofit
- N
- Address line 1
- 7785 N STATE ST
- City
- LOWVILLE
- State
- NY
- Zip code
- 133671229