- Enrollment id
- O20181002003123
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1346794872
- Multiple npi flag
- N
- Ccn
- 553156
- Associate id
- 4284986217
- Organization name
- WISH U WELL HOME HEALTHCARE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6501 FOOTHILL BLVD
- Address line 2
- STE 202A
- City
- TUJUNGA
- State
- CA
- Zip code
- 910422790