- Enrollment id
- O20240820003351
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1376276592
- Multiple npi flag
- N
- Ccn
- 757815
- Associate id
- 1153869219
- Organization name
- GREATER VALLEY HOME HEALTH INC
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 20944 SHERMAN WAY
- Address line 2
- STE 206B
- City
- CANOGA PARK
- State
- CA
- Zip code
- 913033637