- Enrollment id
- O20221026000531
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1467970665
- Multiple npi flag
- N
- Ccn
- 757941
- Associate id
- 8325304355
- Organization name
- ACESO HOME HEALTH CARE
- Incorporation date
- 2017-06-05
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 221 E GLENOAKS BLVD
- Address line 2
- STE 225C
- City
- GLENDALE
- State
- CA
- Zip code
- 912072085