- Enrollment id
- O20240208002257
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1023752755
- Multiple npi flag
- N
- Ccn
- 757750
- Associate id
- 8527401306
- Organization name
- GOOD HOPE HEALTH CARE SERVICES INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12444 VICTORY BLVD
- Address line 2
- STE 411E
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916063199