- Enrollment id
- O20100212000181
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1164758587
- Multiple npi flag
- N
- Ccn
- 059488
- Associate id
- 2163566266
- Organization name
- MID VALLEY HOME HEALTH CARE, INC.
- Incorporation date
- 2009-09-03
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 7220 WOODMAN AVE
- Address line 2
- STE 206
- City
- VAN NUYS
- State
- CA
- Zip code
- 914052668