- Enrollment id
- O20210506001406
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1467061580
- Multiple npi flag
- N
- Ccn
- 559697
- Associate id
- 1951710706
- Organization name
- LOS FELIZ HEALTH CARE INC
- Incorporation date
- 2020-05-11
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 3111 LOS FELIZ BLVD
- Address line 2
- SUITE 203A
- City
- LOS ANGELES
- State
- CA
- Zip code
- 900391585