- Enrollment id
- O20061227000370
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1316000854
- Multiple npi flag
- N
- Ccn
- 058446
- Associate id
- 7214937135
- Organization name
- BURBANK HOME CARE, INC.
- Doing business as name
- HOME HEALTH CARE DYNASTY
- Incorporation date
- 2006-09-15
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 4730 WOODMAN AVE
- Address line 2
- STE 304
- City
- SHERMAN OAKS
- State
- CA
- Zip code
- 914232443