- Enrollment id
- O20040806000955
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1114971280
- Multiple npi flag
- N
- Ccn
- 557194
- Associate id
- 2365414885
- Organization name
- TENDER LOVING CARE HEALTH CARE SERVICES WESTERN, LLC
- Doing business as name
- AMEDISYS HOME HEALTH CARE
- Incorporation date
- 2004-04-07
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 24301 SOUTHLAND DR
- Address line 2
- STE 411
- City
- HAYWARD
- State
- CA
- Zip code
- 945451551