- Enrollment id
- O20160121001238
- Enrollment state
- LA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1538548508
- Multiple npi flag
- N
- Ccn
- 197793
- Associate id
- 3375859333
- Organization name
- JS MANAGEMENT LLC
- Doing business as name
- ST MICHAEL'S HOME HEALTH
- Incorporation date
- 2014-12-17
- Incorporation state
- LA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 332 AMELIA ST
- City
- GRETNA
- State
- LA
- Zip code
- 700535323
- Practice location type
- HHA BRANCH