- Enrollment id
- O20040327000443
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1336144484
- Multiple npi flag
- N
- Ccn
- 557754
- Associate id
- 8123910700
- Organization name
- ASIAN AMERICAN HOME CARE, INC
- Doing business as name
- CENTERWELL ASIAN AMERICAN HOME HEALTH
- Incorporation date
- 1996-06-17
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1301 MARINA VILLAGE PKWY
- Address line 2
- STE 103
- City
- ALAMEDA
- State
- CA
- Zip code
- 945011131