- Enrollment id
- O20180522000749
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1033610266
- Multiple npi flag
- N
- Ccn
- 559107
- Associate id
- 7113282195
- Organization name
- CHANCE HOME CARE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14540 VICTORY BLVD
- Address line 2
- STE 227
- City
- VAN NUYS
- State
- CA
- Zip code
- 914111600