- Enrollment id
- O20170413001060
- Enrollment state
- WA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1669918405
- Multiple npi flag
- N
- Ccn
- 507126
- Associate id
- 5698051241
- Organization name
- SUNNYSIDE HOME HEALTH
- Doing business as name
- ASTRIA HOME HEALTH
- Incorporation date
- 2016-11-21
- Incorporation state
- WA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 812 MILLER AVE
- Address line 2
- STE A
- City
- SUNNYSIDE
- State
- WA
- Zip code
- 989442377
- Practice location type
- HHA BRANCH