- Enrollment id
- O20110627000327
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1205141504
- Multiple npi flag
- N
- Ccn
- 059585
- Associate id
- 7214051515
- Organization name
- ACTIVE PLUS HOME HEALTH CARE, INC.
- Incorporation date
- 2009-03-10
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 4766 PARK GRANADA
- Address line 2
- STE 214
- City
- CALABASAS
- State
- CA
- Zip code
- 913023334