- Enrollment id
- O20201127000064
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1619471695
- Multiple npi flag
- N
- Ccn
- 559597
- Associate id
- 8224458591
- Organization name
- LA PRO HOME HEALTH CARE INC
- Incorporation date
- 2018-02-09
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 16200 VENTURA BLVD
- Address line 2
- STE 307
- City
- ENCINO
- State
- CA
- Zip code
- 914364669