- Enrollment id
- O20201019002505
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1407412828
- Multiple npi flag
- N
- Ccn
- 559343
- Associate id
- 6406276104
- Organization name
- INTEGNA HOME HEALTH LLC
- Incorporation date
- 2019-04-22
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 6131 ORANGETHORPE AVE
- Address line 2
- STE 106
- City
- BUENA PARK
- State
- CA
- Zip code
- 906204901
- Practice location type
- HHA BRANCH