- Enrollment id
- O20021010000021
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1528040284
- Multiple npi flag
- N
- Ccn
- 058172
- Associate id
- 9739096306
- Organization name
- MC HOME HEALTH SERVICES, INC
- Incorporation date
- 2012-08-20
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 18800 AMAR RD B5
- City
- WALNUT
- State
- CA
- Zip code
- 917897100