- Enrollment id
- O20211216000561
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1316556608
- Multiple npi flag
- N
- Ccn
- 559698
- Associate id
- 9335530914
- Organization name
- PERMANENT HOME HEALTH INC
- Incorporation date
- 2020-07-02
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1100 E BROADWAY
- Address line 2
- STE 204
- City
- GLENDALE
- State
- CA
- Zip code
- 912052490