- Enrollment id
- O20200114000012
- Enrollment state
- NV
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1639714967
- Multiple npi flag
- N
- Ccn
- 297149
- Associate id
- 1951674050
- Organization name
- SUMMERLIN HEALTHCARE INC
- Doing business as name
- COMFORT HOME HEALTH
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6655 W SAHARA AVE
- Address line 2
- STE D202
- City
- LAS VEGAS
- State
- NV
- Zip code
- 891460867