- Enrollment id
- O20150826002155
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1699163113
- Multiple npi flag
- N
- Ccn
- 059727
- Associate id
- 5597071258
- Organization name
- NEOGREEN SOLUTIONS INC
- Doing business as name
- NEOGEN CARE
- Incorporation date
- 2010-12-23
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 24301 SOUTHLAND DR
- Address line 2
- STE 401
- City
- HAYWARD
- State
- CA
- Zip code
- 945451550