- Enrollment id
- O20231222001132
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1508527144
- Multiple npi flag
- N
- Ccn
- 757690
- Associate id
- 3274994900
- Organization name
- PRN CARE HOME HEALTH, INC.
- Incorporation date
- 2021-11-29
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6005 VINELAND AVE
- Address line 2
- STE 103
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916064985