- Enrollment id
- O20201214000867
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1740888692
- Multiple npi flag
- N
- Ccn
- 757003
- Associate id
- 9739591983
- Organization name
- SECURE HOME HEALTH SERVICES INC
- Incorporation date
- 2020-09-24
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 13615 VICTORY BLVD
- Address line 2
- STE 106
- City
- VAN NUYS
- State
- CA
- Zip code
- 914011765