- Enrollment id
- O20201116002955
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1578101978
- Multiple npi flag
- N
- Ccn
- 559448
- Associate id
- 7810308269
- Organization name
- GOLDEN LIFE HOME HEALTH, INC.
- Incorporation date
- 2019-11-18
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 7301 TOPANGA CANYON BLVD
- Address line 2
- # 355
- City
- CANOGA PARK
- State
- CA
- Zip code
- 913033395