- Enrollment id
- O20200917003272
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1891311924
- Multiple npi flag
- N
- Ccn
- 369318
- Associate id
- 5799103057
- Organization name
- EQUAL QUALITY CARE LLC
- Incorporation date
- 2020-06-12
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 2586 TILLER LN
- Address line 2
- STE K
- City
- COLUMBUS
- State
- OH
- Zip code
- 432312265