- Enrollment id
- O20160621002790
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1417312984
- Multiple npi flag
- N
- Ccn
- 553124
- Associate id
- 9436440476
- Organization name
- CARE CONNECTION HOME HEALTH AGENCY INC
- Incorporation date
- 2015-11-10
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 19231 VICTORY BLVD
- Address line 2
- STE 259
- City
- RESEDA
- State
- CA
- Zip code
- 913356380
- Practice location type
- HHA BRANCH