- Enrollment id
- O20241014000823
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1639825003
- Multiple npi flag
- N
- Ccn
- 757976
- Associate id
- 1951742535
- Organization name
- CASTLE PINES HOME HEALTH INC
- Incorporation date
- 2022-01-12
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12444 VICTORY BLVD
- Address line 2
- STE 301-U2
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916063199
- Practice location type
- HHA BRANCH