- Enrollment id
- O20230706000292
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1336814144
- Multiple npi flag
- N
- Ccn
- 757453
- Associate id
- 6901265149
- Organization name
- OCEANSIDE HOME HEALTH INC
- Incorporation date
- 2021-08-04
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 7301 TOPANGA CANYON BLVD
- Address line 2
- STE 352
- City
- CANOGA PARK
- State
- CA
- Zip code
- 913031202