- Enrollment id
- O20101215000224
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1912213463
- Multiple npi flag
- N
- Ccn
- 368403
- Associate id
- 2668669706
- Organization name
- L.A. HOME HEALTHCARE, INC
- Incorporation date
- 2010-08-20
- Incorporation state
- OH
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6161 BUSCH BLVD
- Address line 2
- SUITE 206
- City
- COLUMBUS
- State
- OH
- Zip code
- 43229