- Enrollment id
- O20231031000861
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1447903091
- Multiple npi flag
- N
- Ccn
- 758107
- Associate id
- 9335595107
- Organization name
- PEACEFUL HARBORS HOME HEALTH, INC.
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5311 TOPANGA CANYON BLVD
- Address line 2
- STE 209
- City
- WOODLAND HILLS
- State
- CA
- Zip code
- 913641740