- Enrollment id
- O20231122001939
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1255093316
- Multiple npi flag
- N
- Ccn
- 757610
- Associate id
- 5890143341
- Organization name
- PROFESSIONAL & HONEST HOME HEALTH INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 19231 VICTORY BLVD
- Address line 2
- STE 153
- City
- RESEDA
- State
- CA
- Zip code
- 913356308