- Enrollment id
- O20050801000703
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1033301270
- Multiple npi flag
- N
- Ccn
- 058436
- Associate id
- 1951339977
- Organization name
- VISION 6 CORP
- Doing business as name
- INLAND VALLEY HOME HEALTH AGENCY
- Incorporation date
- 2004-11-12
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5050 PALO VERDE ST
- Address line 2
- STE 209
- City
- MONTCLAIR
- State
- CA
- Zip code
- 917632334