- Enrollment id
- O20231025003006
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1427717313
- Multiple npi flag
- N
- Ccn
- 757719
- Associate id
- 5698121770
- Organization name
- RUBY HEARTS HEALTHCARE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 19626 VENTURA BLVD
- Address line 2
- STE 220
- City
- TARZANA
- State
- CA
- Zip code
- 913566026