- Enrollment id
- O20040520001350
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1215079835
- Multiple npi flag
- N
- Ccn
- 058342
- Associate id
- 2860483526
- Organization name
- RC HOME HEALTHCARE INC
- Incorporation date
- 2004-01-05
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1934 W 9TH ST
- Address line 2
- UNIT A
- City
- UPLAND
- State
- CA
- Zip code
- 917865607