- Enrollment id
- O20181010000386
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1629510409
- Multiple npi flag
- N
- Ccn
- 559130
- Associate id
- 1254683865
- Organization name
- HEALTHELECT CARE INC
- Incorporation date
- 2016-11-14
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6742 VAN NUYS BLVD
- Address line 2
- STE 210
- City
- VAN NUYS
- State
- CA
- Zip code
- 914054611