- Enrollment id
- O20120913000393
- Enrollment state
- MO
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1982964086
- Multiple npi flag
- N
- Ccn
- 267642
- Associate id
- 2365690591
- Organization name
- ALPINE HOME HEALTH AGENCY INC
- Incorporation date
- 2012-03-12
- Incorporation state
- MO
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 111 PROSPECT AVE
- Address line 2
- STE 203G
- City
- KIRKWOOD
- State
- MO
- Zip code
- 631226033