- Enrollment id
- O20201022000509
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1437617230
- Multiple npi flag
- N
- Ccn
- 559612
- Associate id
- 3870913346
- Organization name
- MIRACLE TOUCH HOME HEALTH CARE INC
- Incorporation date
- 2020-08-18
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6005 VINELAND AVE
- Address line 2
- STE 201
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916064984