- Enrollment id
- O20051128000734
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1679662456
- Multiple npi flag
- N
- Ccn
- 368162
- Associate id
- 8921028515
- Organization name
- AMERICARE HOME HEALTH AGENCY LLC
- Incorporation date
- 2005-08-17
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 1615 S ALEX RD
- Address line 2
- STE A
- City
- DAYTON
- State
- OH
- Zip code
- 454495407