- Enrollment id
- O20230628001212
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1114648896
- Multiple npi flag
- N
- Ccn
- 757945
- Associate id
- 1254799919
- Organization name
- GRANDVIEW HOME HEALTH CARE, INC.
- Incorporation date
- 2021-06-22
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1220 W GLENOAKS BLVD
- Address line 2
- STE 104
- City
- GLENDALE
- State
- CA
- Zip code
- 912012292