- Enrollment id
- O20231030000582
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1386377570
- Multiple npi flag
- N
- Ccn
- 757676
- Associate id
- 7315393204
- Organization name
- VRV HOME HEALTH CARE INC
- Incorporation date
- 2021-10-19
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14531 HAMLIN ST
- Address line 2
- STE 140
- City
- VAN NUYS
- State
- CA
- Zip code
- 914114125