- Enrollment id
- O20070725000669
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1750587804
- Multiple npi flag
- N
- Ccn
- 059093
- Associate id
- 8527169150
- Organization name
- R & G HOME HEALTH CARE SERVICES INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 539 N GLENOAKS BLVD
- Address line 2
- STE 204B
- City
- BURBANK
- State
- CA
- Zip code
- 915023208