- Enrollment id
- O20240808000667
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1265170963
- Multiple npi flag
- N
- Ccn
- 757918
- Associate id
- 8426592635
- Organization name
- CITYWIDE HOME HEALTH CARE INC
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14542 VENTURA BLVD
- Address line 2
- STE 201
- City
- SHERMAN OAKS
- State
- CA
- Zip code
- 914035544
- Practice location type
- HHA BRANCH