- Enrollment id
- O20241015000926
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1336876556
- Multiple npi flag
- N
- Ccn
- 757990
- Associate id
- 5294267324
- Organization name
- LUCENT HOME HEALTH
- Incorporation date
- 2022-05-31
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 401 N BRAND BLVD
- Address line 2
- STE 824
- City
- GLENDALE
- State
- CA
- Zip code
- 912034427
- Practice location type
- HHA BRANCH