- Enrollment id
- O20201222000883
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1225636210
- Multiple npi flag
- N
- Ccn
- 757070
- Associate id
- 4082026737
- Organization name
- VALLEY CREEK HOME HEALTH
- Incorporation date
- 2018-02-22
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6005 VINELAND AVE
- Address line 2
- STE 214
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916064982