- Enrollment id
- O20160929001284
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1255779187
- Multiple npi flag
- N
- Ccn
- 053157
- Associate id
- 0941437222
- Organization name
- LAKEWOOD HOME HEALTH & PALLIATIVE CARE INC
- Incorporation date
- 2013-04-26
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 539 N GLENOAKS BLVD
- Address line 2
- STE 301F
- City
- BURBANK
- State
- CA
- Zip code
- 915023209