- Enrollment id
- O20200903003200
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1013534981
- Multiple npi flag
- N
- Ccn
- 559746
- Associate id
- 9032536032
- Organization name
- PEARL HOME HEALTH CARE, INC.
- Incorporation date
- 2020-05-27
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1010 N CENTRAL AVE
- Address line 2
- UNIT 240
- City
- GLENDALE
- State
- CA
- Zip code
- 912022937