- Enrollment id
- O20231005000207
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1184383416
- Multiple npi flag
- N
- Ccn
- 757660
- Associate id
- 9032564489
- Organization name
- SOF HOME HEALTH INC
- Incorporation date
- 2021-11-10
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 18401 BURBANK BLVD
- Address line 2
- STE 123
- City
- TARZANA
- State
- CA
- Zip code
- 913562894