- Enrollment id
- O20200103000250
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1073024451
- Multiple npi flag
- N
- Ccn
- 559626
- Associate id
- 1557795333
- Organization name
- GOOD CHOICE HOME CARE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 17050 CHATSWORTH ST
- Address line 2
- STE 228
- City
- GRANADA HILLS
- State
- CA
- Zip code
- 913447828