- Enrollment id
- O20190621000396
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1700383684
- Multiple npi flag
- N
- Ccn
- 559081
- Associate id
- 1658605837
- Organization name
- IHPC HOME HEALTH INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 9017 RESEDA BLVD
- Address line 2
- STE 215
- City
- NORTHRIDGE
- State
- CA
- Zip code
- 913246504