- Enrollment id
- O20210805001284
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1225620305
- Multiple npi flag
- N
- Ccn
- 757007
- Associate id
- 5092119594
- Organization name
- HEALTHYU HOME CARE INC
- Incorporation date
- 2021-01-20
- Incorporation state
- CO
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 2600 FOOTHILL BLVD
- Address line 2
- STE 301
- City
- LA CRESCENTA
- State
- CA
- Zip code
- 912144579
- Practice location type
- HHA BRANCH