- Enrollment id
- O20210615002467
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1164993895
- Multiple npi flag
- N
- Ccn
- 757133
- Associate id
- 8426458258
- Organization name
- ASTRA HOME HEALTH CARE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 11565 LAUREL CANYON BLVD
- Address line 2
- STE 116
- City
- SAN FERNANDO
- State
- CA
- Zip code
- 913404650