- Enrollment id
- O20230823002508
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1376125120
- Multiple npi flag
- N
- Ccn
- 757400
- Associate id
- 7517320591
- Organization name
- GENTLE LOVING CARE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 225 E BROADWAY
- Address line 2
- STE 301E
- City
- GLENDALE
- State
- CA
- Zip code
- 912054098