- Enrollment id
- O20191127000376
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1457780561
- Multiple npi flag
- N
- Ccn
- 559160
- Associate id
- 4789812280
- Organization name
- COMPREHENSIVE HEALTH CARE SERVICES, LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 512 E WILSON AVE
- Address line 2
- STE 200A
- City
- GLENDALE
- State
- CA
- Zip code
- 912064324