- Enrollment id
- O20221020000110
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1457920316
- Multiple npi flag
- N
- Ccn
- 757119
- Associate id
- 5991171720
- Organization name
- A & G HOME HEALTH, INC.
- Incorporation date
- 2021-06-15
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 10117 SEPULVEDA BLVD
- Address line 2
- STE 201E
- City
- MISSION HILLS
- State
- CA
- Zip code
- 913452600