- Enrollment id
- O20130726000427
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1043658602
- Multiple npi flag
- N
- Ccn
- 059677
- Associate id
- 5597906941
- Organization name
- EDEN HOME HEALTH, INC
- Incorporation date
- 2013-04-29
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6300 CANOGA AVE
- Address line 2
- STE 1310
- City
- WOODLAND HILLS
- State
- CA
- Zip code
- 913672555