- Enrollment id
- O20081110000496
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1376792416
- Multiple npi flag
- N
- Ccn
- 059329
- Associate id
- 0547329294
- Organization name
- AT HOME HEALTH SERVICES, INC.
- Incorporation date
- 2008-08-07
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5530 CORBIN AVE
- Address line 2
- STE 228
- City
- TARZANA
- State
- CA
- Zip code
- 913567113
- Practice location type
- HHA BRANCH