- Enrollment id
- O20061030000470
- Enrollment state
- WY
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1730290230
- Multiple npi flag
- N
- Ccn
- 537074
- Associate id
- 7517964810
- Organization name
- ROCK SPRINGS YOUNG AT HEART
- Doing business as name
- YAH HOME HEALTH CARE
- Incorporation date
- 1973-05-30
- Incorporation state
- WY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 2400 REAGAN AVE
- City
- ROCK SPRINGS
- State
- WY
- Zip code
- 829014531