- Enrollment id
- O20240624000228
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1649992082
- Multiple npi flag
- N
- Ccn
- 757895
- Associate id
- 0345783056
- Organization name
- BEST ANGEL HOME HEALTH
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6850 VAN NUYS BLVD
- Address line 2
- STE 209
- City
- VAN NUYS
- State
- CA
- Zip code
- 914054629