- Enrollment id
- O20190129002861
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1548778764
- Multiple npi flag
- N
- Ccn
- 559781
- Associate id
- 5597002584
- Organization name
- CEDAR CARE HOME HEALTH INC
- Incorporation date
- 2017-10-27
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5530 CORBIN AVE
- Address line 2
- STE 375
- City
- TARZANA
- State
- CA
- Zip code
- 913566041