- Enrollment id
- O20140418000231
- Enrollment state
- IN
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1902227002
- Multiple npi flag
- N
- Ccn
- 157677
- Associate id
- 1153553466
- Organization name
- CANNAN HEALTHCARE SERVICES & STAFFING INC
- Incorporation date
- 2013-10-21
- Incorporation state
- IN
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1203 SHEFFIELD AVE
- City
- DYER
- State
- IN
- Zip code
- 463111054