- Enrollment id
- O20190611000552
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1093275620
- Multiple npi flag
- N
- Ccn
- 559289
- Associate id
- 1052644846
- Organization name
- ALLEGIANCE HOME HEALTH SERVICES INC
- Incorporation date
- 2019-03-04
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14435 HAMLIN ST
- Address line 2
- STE 103
- City
- VAN NUYS
- State
- CA
- Zip code
- 914016205
- Practice location type
- HHA BRANCH