- Enrollment id
- O20120117000195
- Enrollment state
- NY
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1700944998
- Multiple npi flag
- N
- Ccn
- 337266
- Associate id
- 6103093158
- Organization name
- PEOPLE HOME HEALTH CARE SERVICES CERTIFIED, INC.
- Incorporation date
- 1993-05-12
- Incorporation state
- NY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 692 MILLERSPORT HWY
- City
- BUFFALO
- State
- NY
- Zip code
- 142262401