- Enrollment id
- O20230308000100
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1669127148
- Multiple npi flag
- N
- Ccn
- 757820
- Associate id
- 0244600161
- Organization name
- HOMEBRIDGE HOME HEALTH INC
- Incorporation date
- 2022-01-24
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 600 N MOUNTAIN AVE
- Address line 2
- STE C205D
- City
- UPLAND
- State
- CA
- Zip code
- 917864315
- Practice location type
- HHA BRANCH