- Enrollment id
- O20150821012818
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1568885606
- Multiple npi flag
- N
- Ccn
- 369155
- Associate id
- 3173838059
- Organization name
- NEW LIFE HOME CARE, LLC
- Incorporation date
- 2013-09-17
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 1415 EAST DUBLIN GRANVILLE RD
- Address line 2
- SUITE 207
- City
- COLUMBUS
- State
- OH
- Zip code
- 43229