- Enrollment id
- O20230606001858
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1588324529
- Multiple npi flag
- N
- Ccn
- 757604
- Associate id
- 0345607388
- Organization name
- ELIT HOME HEALTH CARE, INC.
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 17000 VENTURA BLVD
- Address line 2
- STE 206
- City
- ENCINO
- State
- CA
- Zip code
- 913164184