- Enrollment id
- O20241206003229
- Enrollment state
- GA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1780666321
- Multiple npi flag
- N
- Ccn
- 117141
- Associate id
- 6002898160
- Organization name
- CENTERWELL HEALTH SERVICES USA, LLC
- Doing business as name
- CENTERWELL HOME HEALTH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 2510 ARCHWOOD DR
- Address line 2
- STE 11&12
- City
- ALBANY
- State
- GA
- Zip code
- 317076623