- Enrollment id
- O20070214000025
- Enrollment state
- NJ
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1962479667
- Multiple npi flag
- N
- Ccn
- 317054
- Associate id
- 0648189134
- Organization name
- AHS HOSPITAL CORP
- Doing business as name
- ATLANTIC VISITING NURSE
- Incorporation date
- 1996-05-01
- Incorporation state
- NJ
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 465 SOUTH ST
- Address line 2
- STE 100
- City
- MORRISTOWN
- State
- NJ
- Zip code
- 079606447
- Practice location type
- HHA BRANCH