- Enrollment id
- O20231204001434
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1447863436
- Multiple npi flag
- N
- Ccn
- 757986
- Associate id
- 4284094616
- Organization name
- ENTRUSTED HEALTH CARE PROVIDERS INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12444 VICTORY BLVD
- Address line 2
- STE 415
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916063199