- Enrollment id
- O20230705002744
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1467029769
- Multiple npi flag
- N
- Ccn
- 757843
- Associate id
- 9739548058
- Organization name
- LUMINA HOME HEALTH INC
- Incorporation date
- 2022-05-18
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12235 BEACH BLVD
- Address line 2
- STE 205B
- City
- STANTON
- State
- CA
- Zip code
- 906803962