- Enrollment id
- O20190426000623
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1346769270
- Multiple npi flag
- N
- Ccn
- 559025
- Associate id
- 3072874825
- Organization name
- LUNA PLUS HOME HEALTH, INC.
- Incorporation date
- 2017-08-08
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6308 WOODMAN AVE
- Address line 2
- STE 116
- City
- VAN NUYS
- State
- CA
- Zip code
- 914012380