- Enrollment id
- O20200929003392
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1518506013
- Multiple npi flag
- N
- Ccn
- 559598
- Associate id
- 1254750938
- Organization name
- CONNECT HEALTHCARE LLC
- Incorporation date
- 2018-05-29
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 9700 RESEDA BLVD
- Address line 2
- STE 201
- City
- NORTHRIDGE
- State
- CA
- Zip code
- 913245510
- Practice location type
- HHA BRANCH