- Enrollment id
- O20200318002451
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1528524691
- Multiple npi flag
- N
- Ccn
- 559369
- Associate id
- 6507294923
- Organization name
- TELFAIR HOME HEALTH CARE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1545 N VERDUGO RD
- Address line 2
- STE 101B
- City
- GLENDALE
- State
- CA
- Zip code
- 912082857
- Practice location type
- HHA BRANCH