- Enrollment id
- O20220907001528
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1013646272
- Multiple npi flag
- N
- Ccn
- 757781
- Associate id
- 1052795291
- Organization name
- ASSURITY HOME HEALTH
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14640 VICTORY BLVD
- Address line 2
- STE 212
- City
- VAN NUYS
- State
- CA
- Zip code
- 914111623