- Enrollment id
- O20231218001931
- Enrollment state
- UT
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1588869838
- Multiple npi flag
- N
- Ccn
- 467245
- Associate id
- 5890144745
- Organization name
- REFINED HOME HEALTH AND PERSONAL CARE LLC
- Doing business as name
- REFINED HEALTHCARE SERVICES LLC
- Incorporation date
- 2023-10-11
- Incorporation state
- UT
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 623 E FORT UNION BLVD
- Address line 2
- STE 105
- City
- MIDVALE
- State
- UT
- Zip code
- 840475529