- Enrollment id
- O20151211000885
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1417340456
- Multiple npi flag
- N
- Ccn
- 053187
- Associate id
- 3779884945
- Organization name
- BLISS HOME HEALTH, INC
- Incorporation date
- 2015-02-13
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14349 VICTORY BLVD
- Address line 2
- STE 105B
- City
- VAN NUYS
- State
- CA
- Zip code
- 914011950