- Enrollment id
- O20240821000811
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1306576343
- Multiple npi flag
- N
- Ccn
- 757867
- Associate id
- 3274071287
- Organization name
- AKA HOME HEALTH INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 224 E OLIVE AVE
- Address line 2
- STE 304
- City
- BURBANK
- State
- CA
- Zip code
- 915021251