- Enrollment id
- O20131205001878
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1508208604
- Multiple npi flag
- N
- Ccn
- 369129
- Associate id
- 5193952745
- Organization name
- COMMUNITY HEALTH NETWORK, LTD
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 1660 ENTERPRISE PKWY
- Address line 2
- STE A
- City
- WOOSTER
- State
- OH
- Zip code
- 446917968
- Practice location type
- HHA BRANCH