- Enrollment id
- O20130205000399
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1396082004
- Multiple npi flag
- N
- Ccn
- 059663
- Associate id
- 8224282934
- Organization name
- STAR CENTER GROUP INC.
- Doing business as name
- STAR HOME HEALTH
- Incorporation date
- 2012-05-16
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5958 VINELAND AVE
- Address line 2
- STE K
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916011329