- Enrollment id
- O20210604000469
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1972182418
- Multiple npi flag
- N
- Ccn
- 369329
- Associate id
- 4183023518
- Organization name
- PEACEFUL HOMECARE LLC
- Incorporation date
- 2021-04-16
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 2021 E DUBLIN GRANVILLE RD
- Address line 2
- STE 220
- City
- COLUMBUS
- State
- OH
- Zip code
- 432293522
- Practice location type
- HHA BRANCH