- Enrollment id
- O20200914001529
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1427512474
- Multiple npi flag
- N
- Ccn
- 559318
- Associate id
- 7911325576
- Organization name
- SWEET HOME HEALTH CARE SERVICES INC
- Incorporation date
- 2018-12-21
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 13363 SATICOY ST
- Address line 2
- STE 103
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916053427