- Enrollment id
- O20190816001113
- Enrollment state
- OH
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1003476334
- Multiple npi flag
- N
- Ccn
- 365202
- Associate id
- 1355678111
- Organization name
- CARECORE AT LIMA,LLC
- Doing business as name
- CARECORE AT LIMA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- CARECORE AT LIMA
- Affiliation entity name
- CARECORE HEALTH
- Affiliation entity id
- 108
- Address line 1
- 599 S SHAWNEE ST
- City
- LIMA
- State
- OH
- Zip code
- 458041461