- Enrollment id
- O20220701000198
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1073275681
- Multiple npi flag
- N
- Ccn
- 757479
- Associate id
- 0648650028
- Organization name
- REGIONAL HEALTH SERVICES INC
- Incorporation date
- 2021-09-20
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12501 CHANDLER BLVD
- Address line 2
- STE 206A
- City
- VALLEY VILLAGE
- State
- CA
- Zip code
- 916071941