- Enrollment id
- O20200416000162
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1710447180
- Multiple npi flag
- N
- Ccn
- 559335
- Associate id
- 0446680318
- Organization name
- WHITE GLOVE HOME HEALTH INC
- Incorporation date
- 2018-08-30
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 15643 SHERMAN WAY
- Address line 2
- STE 420
- City
- VAN NUYS
- State
- CA
- Zip code
- 914064183
- Practice location type
- HHA BRANCH