- Enrollment id
- O20230823000952
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1023773256
- Multiple npi flag
- N
- Ccn
- 757985
- Associate id
- 3173986221
- Organization name
- VITA HOME HEALTH CARE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 2139 TAPO ST
- Address line 2
- STE 214
- City
- SIMI VALLEY
- State
- CA
- Zip code
- 930633476