- Enrollment id
- O20190716003648
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1497126296
- Multiple npi flag
- N
- Ccn
- 559128
- Associate id
- 0345575130
- Organization name
- SAGE HOME HEALTH CARE, INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6850 VAN NUYS BLVD
- Address line 2
- STE 216
- City
- VAN NUYS
- State
- CA
- Zip code
- 914054629