- Enrollment id
- O20191021002788
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1235587122
- Multiple npi flag
- N
- Ccn
- 559186
- Associate id
- 5395077523
- Organization name
- LIBERAL HOME HEALTH INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 13363 SATICOY ST
- Address line 2
- STE 106A
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916053400
- Practice location type
- HHA BRANCH