- Enrollment id
- O20211020000787
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1598399826
- Multiple npi flag
- N
- Ccn
- 753163
- Associate id
- 7618365891
- Organization name
- CAPITAL HOME HEALTH CARE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 502 W ROUTE 66
- Address line 2
- SUITE 17A
- City
- GLENDORA
- State
- CA
- Zip code
- 917404343