- Enrollment id
- O20140428001834
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1003245887
- Multiple npi flag
- N
- Ccn
- 059792
- Associate id
- 4587897590
- Organization name
- HEART INC
- Incorporation date
- 2013-09-20
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 4312 WOODMAN AVE
- Address line 2
- STE 201
- City
- SHERMAN OAKS
- State
- CA
- Zip code
- 914235526