- Enrollment id
- O20230224000466
- Enrollment state
- NV
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1942954896
- Multiple npi flag
- N
- Ccn
- 297340
- Associate id
- 0749653699
- Organization name
- PROCARE HOME HEALTH LLC
- Incorporation date
- 2022-02-09
- Incorporation state
- VA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 6655 W SAHARA AVE
- Address line 2
- STE D110
- City
- LAS VEGAS
- State
- NV
- Zip code
- 891460846