- Enrollment id
- O20210326000166
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1386248318
- Multiple npi flag
- N
- Ccn
- 757071
- Associate id
- 5991112567
- Organization name
- IN-HOME HEALTH CARE SUPPORT AND SERVICES LLC
- Doing business as name
- IN-HOME CARE CALIFORNIA
- Incorporation date
- 2020-10-09
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 19626 VENTURA BLVD
- Address line 2
- STE 228
- City
- TARZANA
- State
- CA
- Zip code
- 913566074