- Enrollment id
- O20131016001570
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1992144133
- Multiple npi flag
- N
- Ccn
- 369100
- Associate id
- 2961636444
- Organization name
- CITIZENS HOME HEALTHCARE L.L.C.
- Incorporation date
- 2013-05-29
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 3314 MORSE ROAD
- Address line 2
- SUITE 214
- City
- COLUMBUS
- State
- OH
- Zip code
- 432316100