- Enrollment id
- O20210720000020
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1437774619
- Multiple npi flag
- N
- Ccn
- 757214
- Associate id
- 7810390564
- Organization name
- LIFE START HOME HEALTH CARE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5121 VAN NUYS BLVD
- Address line 2
- STE 203
- City
- SHERMAN OAKS
- State
- CA
- Zip code
- 914036122