- Enrollment id
- O20200422001196
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1639650666
- Multiple npi flag
- N
- Ccn
- 559456
- Associate id
- 4385074947
- Organization name
- VRT HOME HEALTH CARE
- Incorporation date
- 2017-07-10
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 600 W BROADWAY
- Address line 2
- STE 240B
- City
- GLENDALE
- State
- CA
- Zip code
- 912041022