- Enrollment id
- O20220309000103
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1487257549
- Multiple npi flag
- N
- Ccn
- 757005
- Associate id
- 0042604027
- Organization name
- AYVA HOME HEALTH SERVICES INC
- Incorporation date
- 2020-10-02
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 20944 SHERMAN WAY
- Address line 2
- STE 209
- City
- CANOGA PARK
- State
- CA
- Zip code
- 913033642