- Enrollment id
- O20060815000353
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1023078763
- Multiple npi flag
- N
- Ccn
- 557731
- Associate id
- 5395748214
- Organization name
- CELEBRITY HEALTH SERVICES, INC.
- Doing business as name
- CELEBRITY HOMEHEALTH
- Incorporation date
- 1991-01-01
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14950 VENTURA BLVD
- City
- SHERMAN OAKS
- State
- CA
- Zip code
- 914033455