- Enrollment id
- O20240221000664
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1710692835
- Multiple npi flag
- N
- Ccn
- 757887
- Associate id
- 9335583061
- Organization name
- PEACEFUL HOME HEALTH, INC.
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 300 N 3RD ST
- Address line 2
- STE 307
- City
- BURBANK
- State
- CA
- Zip code
- 915021107