- Enrollment id
- O20201130002671
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1215534078
- Multiple npi flag
- N
- Ccn
- 757822
- Associate id
- 4981015773
- Organization name
- SERANI HOMEHEALTH
- Incorporation date
- 2020-10-05
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14545 FRIAR ST
- Address line 2
- STE 237E
- City
- VAN NUYS
- State
- CA
- Zip code
- 914114719