- Enrollment id
- O20210614000375
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1235769845
- Multiple npi flag
- N
- Ccn
- 559708
- Associate id
- 5193125185
- Organization name
- HERA HOME HEALTH INC
- Incorporation date
- 2019-11-27
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 9221 CORBIN AVE
- Address line 2
- STE 220
- City
- NORTHRIDGE
- State
- CA
- Zip code
- 913242494