- Enrollment id
- O20201229001387
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1780282533
- Multiple npi flag
- N
- Ccn
- 757037
- Associate id
- 0244643815
- Organization name
- WHITE ORCHID HOME HEALTH
- Incorporation date
- 2020-10-05
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 16661 VENTURA BLVD
- Address line 2
- STE 223
- City
- ENCINO
- State
- CA
- Zip code
- 914361944