- Enrollment id
- O20070816000758
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1740481241
- Multiple npi flag
- N
- Ccn
- 059171
- Associate id
- 7719079078
- Organization name
- MAJESTIC HOME HEALTH CARE, INC.
- Incorporation date
- 2007-05-10
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5121 VAN NUYS BLVD
- Address line 2
- STE 302
- City
- SHERMAN OAKS
- State
- CA
- Zip code
- 914036130