- Enrollment id
- O20200825002261
- Enrollment state
- CO
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1780215194
- Multiple npi flag
- N
- Ccn
- 067607
- Associate id
- 4587081393
- Organization name
- AVIDA HOME HEALTH LLC
- Incorporation date
- 2020-02-04
- Incorporation state
- CO
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 6595 S DAYTON ST
- Address line 2
- STE 3400
- City
- GREENWOOD VILLAGE
- State
- CO
- Zip code
- 801116155