- Enrollment id
- O20111109000496
- Enrollment state
- MA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1497988190
- Multiple npi flag
- N
- Ccn
- 227536
- Associate id
- 9537207360
- Organization name
- AT HOME SENIOR CARE, INC.
- Incorporation date
- 2009-08-25
- Incorporation state
- MA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 36 JACONNET ST
- Address line 2
- # 104
- City
- NEWTON
- State
- MA
- Zip code
- 024611900