- Enrollment id
- O20250322000079
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1730996919
- Multiple npi flag
- N
- Ccn
- 369413
- Associate id
- 5698297372
- Organization name
- EXTENDED HANDS HOME HEALTH, LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 1495 MORSE RD
- Address line 2
- STE 305
- City
- COLUMBUS
- State
- OH
- Zip code
- 432296434