- Enrollment id
- O20180126001451
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1669880290
- Multiple npi flag
- N
- Ccn
- 053163
- Associate id
- 4385904077
- Organization name
- PROFESSIONAL CARE HOSPICE AND HOME HEALTH, INC.
- Doing business as name
- PROFESSIONAL HOME HEALTH
- Incorporation date
- 2012-07-05
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 13701 RIVERSIDE DR
- Address line 2
- STE 701
- City
- SHERMAN OAKS
- State
- CA
- Zip code
- 914232467
- Practice location type
- HHA BRANCH