- Enrollment id
- O20251028002843
- Enrollment state
- MI
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1346124781
- Multiple npi flag
- N
- Ccn
- 235361
- Associate id
- 2062901325
- Organization name
- NILES CARE CENTER LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- NILES CARE CENTER, LLC
- Affiliation entity name
- AVON HEALTHCARE
- Affiliation entity id
- 840
- Address line 1
- 911 S 3RD STREET
- City
- NILES
- State
- MI
- Zip code
- 491203414