- Enrollment id
- O20070227000611
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1689715674
- Multiple npi flag
- N
- Ccn
- 058467
- Associate id
- 6002918711
- Organization name
- EGIDA HOME HEALTH CARE, INC.
- Incorporation date
- 2006-12-21
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 13701 RIVERSIDE DR
- Address line 2
- STE 316
- City
- SHERMAN OAKS
- State
- CA
- Zip code
- 914232447
- Practice location type
- HHA BRANCH