- Enrollment id
- O20240621001814
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1205563251
- Multiple npi flag
- N
- Ccn
- 758087
- Associate id
- 0143763862
- Organization name
- CHATEAU HOME HEALTH INC
- Incorporation date
- 2022-01-10
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12444 VICTORY BLVD
- Address line 2
- STE 301-U
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916063199