- Enrollment id
- O20210519003094
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1093393472
- Multiple npi flag
- N
- Ccn
- 753135
- Associate id
- 2860891058
- Organization name
- KAELIN'S HOME HEALTH,INC.
- Incorporation date
- 2021-03-22
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 7301 TOPANGA CANYON BLVD
- Address line 2
- STE 375
- City
- CANOGA PARK
- State
- CA
- Zip code
- 913033395