- Enrollment id
- O20061115000338
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1366528408
- Multiple npi flag
- N
- Ccn
- 058442
- Associate id
- 5597763144
- Organization name
- SUMMIT HOME HEALTH, INC
- Doing business as name
- ANGELS OF SUMMIT HOME HEALTH
- Incorporation date
- 2006-06-29
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 2139 TAPO ST
- Address line 2
- STE 210
- City
- SIMI VALLEY
- State
- CA
- Zip code
- 930633476