- Enrollment id
- O20090526000093
- Enrollment state
- FL
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1619960341
- Multiple npi flag
- N
- Ccn
- 107653
- Associate id
- 6507898160
- Organization name
- HOME NURSE CORP.
- Doing business as name
- THE PALACE AT HOME
- Incorporation date
- 1996-10-17
- Incorporation state
- FL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 10850 SW 113TH PLACE
- City
- MIAMI
- State
- FL
- Zip code
- 331763227