- Enrollment id
- O20230329001249
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1609535491
- Multiple npi flag
- N
- Ccn
- 757557
- Associate id
- 3072987288
- Organization name
- REAL CARE HOME HEALTH
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 7335 VAN NUYS BLVD
- Address line 2
- STE 107B
- City
- VAN NUYS
- State
- CA
- Zip code
- 914051951