- Enrollment id
- O20210720001091
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1407448756
- Multiple npi flag
- N
- Ccn
- 757049
- Associate id
- 9234547316
- Organization name
- NOOR HOME HEALTH
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 315 ARDEN AVE
- Address line 2
- STE 5
- City
- GLENDALE
- State
- CA
- Zip code
- 912031163