- Enrollment id
- O20170816001930
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1770013617
- Multiple npi flag
- N
- Ccn
- 559379
- Associate id
- 5193097863
- Organization name
- ST. RITA'S HOME HEALTH CARE INC
- Incorporation date
- 2017-06-01
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6360 VAN NUYS BLVD
- Address line 2
- STE 233
- City
- VAN NUYS
- State
- CA
- Zip code
- 914016615