- Enrollment id
- O20100216000599
- Enrollment state
- NJ
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1952402737
- Multiple npi flag
- N
- Ccn
- 317047
- Associate id
- 1153465075
- Organization name
- AMEDISYS NEW JERSEY, LLC
- Doing business as name
- AMEDISYS HOME HEALTH
- Incorporation date
- 2009-09-01
- Incorporation state
- NJ
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 21 MAIN ST
- Address line 2
- STE 252
- City
- HACKENSACK
- State
- NJ
- Zip code
- 076017086