- Enrollment id
- O20230821002432
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1336890045
- Multiple npi flag
- N
- Ccn
- 757404
- Associate id
- 3072975176
- Organization name
- OLIVIA'S HOME HEALTH CARE, INC
- Incorporation date
- 2021-09-09
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 121 W LEXINGTON DR
- Address line 2
- STE L400F
- City
- GLENDALE
- State
- CA
- Zip code
- 912032230