- Enrollment id
- O20250212002310
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1639943053
- Multiple npi flag
- N
- Ccn
- 758110
- Associate id
- 5092245514
- Organization name
- MOTHER NATURE HEALTHCARE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 260 S LOS ROBLES AVE
- Address line 2
- STE 337
- City
- PASADENA
- State
- CA
- Zip code
- 911013626