- Enrollment id
- O20210916000503
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1689251050
- Multiple npi flag
- N
- Ccn
- 757126
- Associate id
- 6800290685
- Organization name
- AMK HOME HEALTH CARE INC
- Incorporation date
- 2021-02-15
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14349 VICTORY BLVD
- Address line 2
- UNIT 307
- City
- VAN NUYS
- State
- CA
- Zip code
- 914011950