- Enrollment id
- O20091105000201
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1619200326
- Multiple npi flag
- N
- Ccn
- 368318
- Associate id
- 9133267560
- Organization name
- AUTUMN SPRINGS HEALTH CARE SERVICES INC
- Incorporation date
- 2009-09-01
- Incorporation state
- OH
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6422 E MAIN ST
- Address line 2
- STE 202
- City
- REYNOLDSBURG
- State
- OH
- Zip code
- 430682302