- Enrollment id
- O20091222000159
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1710006630
- Multiple npi flag
- N
- Ccn
- 368430
- Associate id
- 2466545264
- Organization name
- CRESCENT HOME HEALTH CARE, LLC
- Incorporation date
- 2007-01-29
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 6161 BUSCH BLVD.
- Address line 2
- SUITE 313
- City
- COLUMBUS
- State
- OH
- Zip code
- 432292555