- Enrollment id
- O20230606002377
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1700549482
- Multiple npi flag
- N
- Ccn
- 757550
- Associate id
- 8426415472
- Organization name
- CREED HOME HEALTH CARE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6742 VAN NUYS BLVD
- Address line 2
- STE 111
- City
- VAN NUYS
- State
- CA
- Zip code
- 914054611