- Enrollment id
- O20250224001844
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1376254219
- Multiple npi flag
- N
- Ccn
- 758080
- Associate id
- 9133649908
- Organization name
- ROSE VILLA HOME HEALTH,INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 9700 RESEDA BLVD
- Address line 2
- STE 209
- City
- NORTHRIDGE
- State
- CA
- Zip code
- 913245506