- Enrollment id
- O20090402000216
- Enrollment state
- IL
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1639324429
- Multiple npi flag
- N
- Ccn
- 148091
- Associate id
- 5496802704
- Organization name
- SELECT HOME CARE, INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 9933 LAWLER AVE
- Address line 2
- STE 525A
- City
- SKOKIE
- State
- IL
- Zip code
- 600773703
- Practice location type
- HHA BRANCH