- Enrollment id
- O20200826000846
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1659844439
- Multiple npi flag
- N
- Ccn
- 559410
- Associate id
- 5496172165
- Organization name
- WISH HOME HEALTH CARE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 500 E OLIVE AVE
- Address line 2
- STE 670
- City
- BURBANK
- State
- CA
- Zip code
- 915012197