- Enrollment id
- O20231003000912
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1497320527
- Multiple npi flag
- N
- Ccn
- 757743
- Associate id
- 4587018072
- Organization name
- SERA HEALTHCARE
- Incorporation date
- 2021-05-05
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 300 N 3RD ST
- Address line 2
- STE 254
- City
- BURBANK
- State
- CA
- Zip code
- 915021107
- Practice location type
- HHA BRANCH