- Enrollment id
- O20231030001100
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1801577630
- Multiple npi flag
- N
- Ccn
- 369384
- Associate id
- 8325494222
- Organization name
- OPTIMAL HOME CARE LLC
- Incorporation date
- 2023-07-25
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 5900 ROCHE DR
- Address line 2
- STE 425
- City
- COLUMBUS
- State
- OH
- Zip code
- 432293293