- Enrollment id
- O20170203001115
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1871040477
- Multiple npi flag
- N
- Ccn
- 369188
- Associate id
- 7810270550
- Organization name
- NORTHSTAR HOME HEALTHCARE, LLC
- Incorporation date
- 2016-07-05
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 1495 MORSE RD
- Address line 2
- STE 306
- City
- COLUMBUS
- State
- OH
- Zip code
- 432296434