- Enrollment id
- O20060901000174
- Enrollment state
- MI
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1609896208
- Multiple npi flag
- N
- Ccn
- 237659
- Associate id
- 0244234334
- Organization name
- JOHN PAUL HOME CARE LLC
- Incorporation date
- 2005-10-28
- Incorporation state
- MI
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 30800 TELEGRAPH RD
- Address line 2
- STE 3700
- City
- BINGHAM FARMS
- State
- MI
- Zip code
- 480254583
- Practice location type
- HHA BRANCH