- Enrollment id
- O20200605000045
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1093360976
- Multiple npi flag
- N
- Ccn
- 559312
- Associate id
- 2769803477
- Organization name
- FIRST AMERICAN HOME HEALTH INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 436 W COLORADO ST
- Address line 2
- STE 213
- City
- GLENDALE
- State
- CA
- Zip code
- 912041568