- Enrollment id
- O20080414000235
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1578614087
- Multiple npi flag
- N
- Ccn
- 557790
- Associate id
- 5597842617
- Organization name
- PRECAUTIONARY HOME HEALTH SERVICES
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 11011 CRENSHAW BLVD
- Address line 2
- STE 203
- City
- INGLEWOOD
- State
- CA
- Zip code
- 903036334