- Enrollment id
- O20220907000466
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1780266817
- Multiple npi flag
- N
- Ccn
- 757217
- Associate id
- 1456735679
- Organization name
- EXCELLENT HOME CARE INC
- Incorporation date
- 2021-03-22
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5311 TOPANGA CANYON BLVD
- Address line 2
- STE 205
- City
- WOODLAND HILLS
- State
- CA
- Zip code
- 913641770