- Enrollment id
- O20220429000767
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1194330563
- Multiple npi flag
- N
- Ccn
- 757013
- Associate id
- 0749677342
- Organization name
- PLATINUM HEALTH CARE SERVICES, INC
- Incorporation date
- 2020-09-02
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 8001 LAUREL CANYON BLVD
- Address line 2
- STE 103
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916051456
- Practice location type
- HHA BRANCH