- Enrollment id
- O20120531000148
- Enrollment state
- NC
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1760470660
- Multiple npi flag
- N
- Ccn
- 347002
- Associate id
- 0547423568
- Organization name
- WELL CARE HOME HEALTH, INC
- Doing business as name
- WELL CARE HOME HEALTH, INC.
- Incorporation date
- 2000-09-21
- Incorporation state
- NC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 131 RACINE DR
- Address line 2
- STE 201
- City
- WILMINGTON
- State
- NC
- Zip code
- 284038752
- Practice location type
- HHA BRANCH