- Enrollment id
- O20230605002652
- Enrollment state
- IL
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1952909996
- Multiple npi flag
- N
- Ccn
- 148409
- Associate id
- 4880051960
- Organization name
- FRONTLINE HEALTHCARE LLC
- Incorporation date
- 2020-05-28
- Incorporation state
- IL
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 9933 LAWLER AVE
- Address line 2
- STE 215
- City
- SKOKIE
- State
- IL
- Zip code
- 600773757