- Enrollment id
- O20240216002291
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1588319552
- Multiple npi flag
- N
- Ccn
- 757801
- Associate id
- 1254775372
- Organization name
- COMMUNITY ADULT HOME HEALTH CARE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 13615 VICTORY BLVD
- Address line 2
- STE 118
- City
- VAN NUYS
- State
- CA
- Zip code
- 914011777