- Enrollment id
- O20170309001810
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1548703291
- Multiple npi flag
- N
- Ccn
- 053164
- Associate id
- 7517241698
- Organization name
- KEY TO HEALTH HOMECARE INC
- Incorporation date
- 2016-04-27
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 664 W BROADWAY
- Address line 2
- STE G
- City
- GLENDALE
- State
- CA
- Zip code
- 912041097