- Enrollment id
- O20080604000235
- Enrollment state
- MS
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1972509099
- Multiple npi flag
- N
- Ccn
- 257303
- Associate id
- 8224108105
- Organization name
- GILBERT'S HOME HEALTH AGENCY, INC.
- Doing business as name
- CENTERWELL HOME HEALTH
- Incorporation date
- 1996-12-31
- Incorporation state
- MS
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 3402 W MAIN ST
- City
- TUPELO
- State
- MS
- Zip code
- 388019412