- Enrollment id
- O20180418000770
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1225499742
- Multiple npi flag
- N
- Ccn
- 559219
- Associate id
- 3577826981
- Organization name
- QUANTUM HOME HEALTH SERVICES INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 520 E WILSON AVE
- Address line 2
- STE 215
- City
- GLENDALE
- State
- CA
- Zip code
- 912064374
- Practice location type
- HHA BRANCH