- Enrollment id
- O20240808003731
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1043881295
- Multiple npi flag
- N
- Ccn
- 758085
- Associate id
- 2365989209
- Organization name
- DEDICATED HEALTH CARE MANAGEMENT
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 21151 S WESTERN AVE
- Address line 2
- STE 206
- City
- TORRANCE
- State
- CA
- Zip code
- 905011724