- Enrollment id
- O20201203001162
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1477165843
- Multiple npi flag
- N
- Ccn
- 369291
- Associate id
- 8729499306
- Organization name
- EQUAL HOME CARE LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 5900 ROCHE DR
- Address line 2
- STE 600H
- City
- COLUMBUS
- State
- OH
- Zip code
- 432293337