- Enrollment id
- O20240102001368
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1396491882
- Multiple npi flag
- N
- Ccn
- 757741
- Associate id
- 8921458068
- Organization name
- AMAZING HEALTH CARE SERVICES INC
- Incorporation date
- 2022-01-10
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 17050 CHATSWORTH ST
- Address line 2
- STE 213
- City
- GRANADA HILLS
- State
- CA
- Zip code
- 913447808