- Enrollment id
- O20070614000699
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1306069737
- Multiple npi flag
- N
- Ccn
- 058426
- Associate id
- 1153429147
- Organization name
- ADVANCED HOME HEALTH INC
- Doing business as name
- ADVANCED HOME HEALTH AND HOSPICE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 4362 AUBURN BLVD
- Address line 2
- STE 300
- City
- SACRAMENTO
- State
- CA
- Zip code
- 958414107
- Practice location type
- HHA BRANCH