- Enrollment id
- O20240624004245
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1699421677
- Multiple npi flag
- N
- Ccn
- 758083
- Associate id
- 8527501105
- Organization name
- GREENWAY HOME HEALTH CARE INC
- Incorporation date
- 2022-01-03
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12444 VICTORY BLVD
- Address line 2
- STE 301-V
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916063199