- Enrollment id
- O20151214000955
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1003286873
- Multiple npi flag
- N
- Ccn
- 553184
- Associate id
- 7911208152
- Organization name
- GOLDEN STAR HOME HEALTH CARE, INC.
- Doing business as name
- GOLDEN STAR HOME HEALTH CARE
- Incorporation date
- 2015-09-21
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 440 W COLORADO ST
- Address line 2
- STE 205
- City
- GLENDALE
- State
- CA
- Zip code
- 912043056