- Enrollment id
- O20221122001216
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1588243877
- Multiple npi flag
- N
- Ccn
- 757306
- Associate id
- 4880062926
- Organization name
- HOUSE OF HEALTH HOME CARE AGENCY INC
- Incorporation date
- 2021-01-04
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 2321 W OLIVE AVE
- Address line 2
- STE A
- City
- BURBANK
- State
- CA
- Zip code
- 915062603