- Enrollment id
- O20201030002034
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1104437763
- Multiple npi flag
- N
- Ccn
- 559676
- Associate id
- 2961812078
- Organization name
- ALL INCLUSIVE HOME CARE INC
- Incorporation date
- 2020-07-30
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6819 SEPULVEDA BLVD
- Address line 2
- STE 206
- City
- VAN NUYS
- State
- CA
- Zip code
- 914054440