- Enrollment id
- O20210202001937
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1629639927
- Multiple npi flag
- N
- Ccn
- 559511
- Associate id
- 5597179523
- Organization name
- GRANADA HILLS HOME HEALTH CARE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 9221 CORBIN AVE
- Address line 2
- STE 245
- City
- NORTHRIDGE
- State
- CA
- Zip code
- 913241685