- Enrollment id
- O20160919002711
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1881960565
- Multiple npi flag
- N
- Ccn
- 369200
- Associate id
- 0749577765
- Organization name
- 21ST CENTURY HOME HEALTH SERVICES LLC
- Incorporation date
- 2012-03-20
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 635 PARK MEADOW RD
- Address line 2
- STE 207
- City
- WESTERVILLE
- State
- OH
- Zip code
- 430812877