- Enrollment id
- O20221228000101
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1225609969
- Multiple npi flag
- N
- Ccn
- 757202
- Associate id
- 4284004706
- Organization name
- PURE HANDS HOME HEALTH INC
- Incorporation date
- 2021-06-17
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 13615 VICTORY BLVD
- Address line 2
- STE 208
- City
- VAN NUYS
- State
- CA
- Zip code
- 914011790