- Enrollment id
- O20200615001363
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1699324392
- Multiple npi flag
- N
- Ccn
- 559479
- Associate id
- 6608298906
- Organization name
- GAMMA HOME HEALTH INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 7590 N GLENOAKS BLVD
- Address line 2
- STE 12
- City
- BURBANK
- State
- CA
- Zip code
- 915041003