- Enrollment id
- O20241029000458
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1144976820
- Multiple npi flag
- N
- Ccn
- 757988
- Associate id
- 1254864366
- Organization name
- SWEET ANGELS HEALTH SERVICES INC
- Incorporation date
- 2022-01-10
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14545 FRIAR ST
- Address line 2
- # 185
- City
- VAN NUYS
- State
- CA
- Zip code
- 914112397
- Practice location type
- HHA BRANCH