- Enrollment id
- O20241106003090
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1518681097
- Multiple npi flag
- N
- Ccn
- 758210
- Associate id
- 7315478583
- Organization name
- HIGH STAR HOME HEALTH
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 22024 LASSEN ST
- Address line 2
- STE 121
- City
- CHATSWORTH
- State
- CA
- Zip code
- 913118330
- Practice location type
- HHA BRANCH