- Enrollment id
- O20070316000457
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1013046416
- Multiple npi flag
- N
- Ccn
- 059045
- Associate id
- 3971606625
- Organization name
- OPTIMUM HOME HEALTHCARE, INC.
- Incorporation date
- 2006-09-25
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 20121 VENTURA BLVD
- Address line 2
- STE 302
- City
- WOODLAND HILLS
- State
- CA
- Zip code
- 913642559