- Enrollment id
- O20240913001183
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1710511050
- Multiple npi flag
- N
- Ccn
- 757932
- Associate id
- 8729492558
- Organization name
- G&D HOME HEALTH
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6360 VAN NUYS BLVD
- Address line 2
- STE 166
- City
- VAN NUYS
- State
- CA
- Zip code
- 914016657