- Enrollment id
- O20210623001652
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1265944813
- Multiple npi flag
- N
- Ccn
- 559717
- Associate id
- 0941568984
- Organization name
- BRIGHTSIDE HOME HEALTH CARE INC
- Incorporation date
- 2017-08-17
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 8949 RESEDA BLVD
- Address line 2
- STE 203
- City
- NORTHRIDGE
- State
- CA
- Zip code
- 913245819