- Enrollment id
- O20200212002510
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1063071744
- Multiple npi flag
- N
- Ccn
- 559791
- Associate id
- 4082040944
- Organization name
- AMERICAN ATA HOME HEALTH AGENCY INC
- Incorporation date
- 2019-05-06
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5311 TOPANGA CANYON BLVD
- Address line 2
- STE 202
- City
- WOODLAND HILLS
- State
- CA
- Zip code
- 913641771