- Enrollment id
- O20230918002641
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1518627405
- Multiple npi flag
- N
- Ccn
- 757809
- Associate id
- 7416311832
- Organization name
- UNITED HOME HEALTH CARE AGENCY
- Incorporation date
- 2021-11-03
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 171 N ALTADENA DR
- Address line 2
- STE 222
- City
- PASADENA
- State
- CA
- Zip code
- 911077319