- Enrollment id
- O20060502000661
- Enrollment state
- OK
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1841222585
- Multiple npi flag
- N
- Ccn
- 377708
- Associate id
- 1254341407
- Organization name
- FAITH HOME CARE SERVICES, LLC
- Doing business as name
- FAITH HOME CARE SERVICES LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 2530 E 71ST ST
- Address line 2
- STE H
- City
- TULSA
- State
- OK
- Zip code
- 741365577