- Enrollment id
- O20230413001879
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1336874098
- Multiple npi flag
- N
- Ccn
- 757513
- Associate id
- 1456726074
- Organization name
- GOLDEN CARE HOME HEALTH INC
- Incorporation date
- 2021-10-13
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14545 FRIAR ST
- Address line 2
- STE 297
- City
- VAN NUYS
- State
- CA
- Zip code
- 914112397