- Enrollment id
- O20080903000431
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1437311610
- Multiple npi flag
- N
- Ccn
- 059271
- Associate id
- 0244306926
- Organization name
- INDEPENDENCE HOME HEALTH INC.
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6501 FOOTHILL BLVD
- Address line 2
- STE 201C
- City
- TUJUNGA
- State
- CA
- Zip code
- 910422790
- Practice location type
- HHA BRANCH