- Enrollment id
- O20241014002718
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1174245104
- Multiple npi flag
- N
- Ccn
- 757814
- Associate id
- 7719419878
- Organization name
- HEALING SOULS HOME HEALTH CARE
- Incorporation date
- 2022-06-09
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6501 FOOTHILL BLVD
- Address line 2
- STE 204A
- City
- TUJUNGA
- State
- CA
- Zip code
- 910422768