- Enrollment id
- O20120420000147
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1487929162
- Multiple npi flag
- N
- Ccn
- 059690
- Associate id
- 3476714353
- Organization name
- LA GUARDIAN HEALTH CARE INC
- Incorporation date
- 2012-02-27
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6501 FOOTHILL BLVD
- Address line 2
- STE 203B
- City
- TUJUNGA
- State
- CA
- Zip code
- 910422768
- Practice location type
- HHA BRANCH