- Enrollment id
- O20201230002441
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1528664091
- Multiple npi flag
- N
- Ccn
- 369325
- Associate id
- 7911310461
- Organization name
- ASEDARA HEALTHCARE SERVICES, LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 2244 S HAMILTON RD
- Address line 2
- STE 203
- City
- COLUMBUS
- State
- OH
- Zip code
- 432324390