- Enrollment id
- O20220405000979
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1649884875
- Multiple npi flag
- N
- Ccn
- 757038
- Associate id
- 8325434178
- Organization name
- ONE UP HOME HEALTH CARE INC
- Incorporation date
- 2020-06-08
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12444 VICTORY BLVD
- Address line 2
- STE 405
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916063199