- Enrollment id
- O20200813003257
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1679576607
- Multiple npi flag
- N
- Ccn
- 557266
- Associate id
- 5991121469
- Organization name
- EMERALD HOME HEALTH INC
- Incorporation date
- 2018-08-27
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5775 E LOS ANGELES AVE
- Address line 2
- STE 232
- City
- SIMI VALLEY
- State
- CA
- Zip code
- 930635215
- Practice location type
- HHA BRANCH