- Enrollment id
- O20211020000751
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1750053534
- Multiple npi flag
- N
- Ccn
- 369337
- Associate id
- 2264820448
- Organization name
- ULTIMATE HOME HEALTHCARE LLC
- Incorporation date
- 2021-05-14
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- N
- Address line 1
- 1150 MORSE RD
- Address line 2
- STE 335
- City
- COLUMBUS
- State
- OH
- Zip code
- 432296327