- Enrollment id
- O20190117001410
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1689146433
- Multiple npi flag
- N
- Ccn
- 559681
- Associate id
- 8628314317
- Organization name
- PARADISE HOME HEALTH OF LOS ANGELES INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5530 CORBIN AVE
- Address line 2
- STE 220
- City
- TARZANA
- State
- CA
- Zip code
- 913563096