- Enrollment id
- O20070425000363
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1023130432
- Multiple npi flag
- N
- Ccn
- 058480
- Associate id
- 7113022880
- Organization name
- HOLLYWOOD HEALTH SERVICES, INC.
- Doing business as name
- ANI HEALTH SERVICES
- Incorporation date
- 2006-01-23
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 4312 WOODMAN AVE
- Address line 2
- STE 201
- City
- SHERMAN OAKS
- State
- CA
- Zip code
- 914235526