- Enrollment id
- O20231026000321
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1437803202
- Multiple npi flag
- N
- Ccn
- 757871
- Associate id
- 4183070295
- Organization name
- AVIVA HEALTH SERVICES, INC.
- Incorporation date
- 2022-01-28
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12722 RIVERSIDE DR
- Address line 2
- STE 105A
- City
- VALLEY VILLAGE
- State
- CA
- Zip code
- 916073326