- Enrollment id
- O20200811001804
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1003477035
- Multiple npi flag
- N
- Ccn
- 559457
- Associate id
- 0648696435
- Organization name
- MONROE HOME HEALTH CARE INC
- Incorporation date
- 2019-01-16
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 225 E BROADWAY
- Address line 2
- STE B112
- City
- GLENDALE
- State
- CA
- Zip code
- 912051008
- Practice location type
- HHA BRANCH