- Enrollment id
- O20190918001242
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1558852418
- Multiple npi flag
- N
- Ccn
- 559136
- Associate id
- 6406186451
- Organization name
- ALPHA HOME HEALTH AGENCY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1220 W GLENOAKS BLVD
- Address line 2
- STE 201
- City
- GLENDALE
- State
- CA
- Zip code
- 912014101