- Enrollment id
- O20240925002258
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1336898246
- Multiple npi flag
- N
- Ccn
- 758094
- Associate id
- 2668913021
- Organization name
- CITY HHA INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 401 N BRAND BLVD
- Address line 2
- STE 401G
- City
- GLENDALE
- State
- CA
- Zip code
- 912034468