- Enrollment id
- O20080229000054
- Enrollment state
- IL
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1508065087
- Multiple npi flag
- N
- Ccn
- 148031
- Associate id
- 1759465735
- Organization name
- DEVOTED HEALTH CARE, INC.
- Incorporation date
- 2005-12-15
- Incorporation state
- IL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 2720 S RIVER RD
- Address line 2
- STE 4
- City
- DES PLAINES
- State
- IL
- Zip code
- 600184109