- Enrollment id
- O20120824000343
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1649526138
- Multiple npi flag
- N
- Ccn
- 369113
- Associate id
- 2769393719
- Organization name
- FAMILY CHOICE HOME HEALTHCARE SERVICES, LLC
- Incorporation date
- 2003-07-07
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 2021 E. DUBLIN-GRANVILLE ROAD
- Address line 2
- SUITE 136
- City
- COLUMBUS
- State
- OH
- Zip code
- 432292254