- Enrollment id
- O20180328002033
- Enrollment state
- SC
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1750897609
- Multiple npi flag
- N
- Ccn
- 427015
- Associate id
- 0345501649
- Organization name
- INSPIRIUM IHC UPSTATE, LLC
- Doing business as name
- INTERIM HEALTHCARE OF THE UPSTATE
- Incorporation date
- 2017-08-02
- Incorporation state
- SC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 100 VERDAE BLVD STE 300
- City
- GREENVILLE
- State
- SC
- Zip code
- 296073857