- Enrollment id
- O20231006002455
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1548937295
- Multiple npi flag
- N
- Ccn
- 758073
- Associate id
- 0244685519
- Organization name
- ACUTE HOME HEALTH
- Incorporation date
- 2021-08-04
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14531 HAMLIN ST
- Address line 2
- STE 104
- City
- VAN NUYS
- State
- CA
- Zip code
- 914114140