- Enrollment id
- O20050726000985
- Enrollment state
- AL
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1861575334
- Multiple npi flag
- N
- Ccn
- 017097
- Associate id
- 7911934476
- Organization name
- CLAY COUNTY HOSPITAL HOME CARE, LLC
- Incorporation date
- 2004-09-29
- Incorporation state
- AL
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 83825 HIGHWAY 9
- City
- ASHLAND
- State
- AL
- Zip code
- 362517981