- Enrollment id
- O20200821001756
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1013526268
- Multiple npi flag
- N
- Ccn
- 757076
- Associate id
- 2163848094
- Organization name
- PATHWAY HOME HEALTH SERVICES INC
- Incorporation date
- 2020-06-29
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 127 S BRAND BLVD
- Address line 2
- STE 208A
- City
- GLENDALE
- State
- CA
- Zip code
- 912041372