- Enrollment id
- O20180730000052
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1790200913
- Multiple npi flag
- N
- Ccn
- 559171
- Associate id
- 3971850561
- Organization name
- VIGOROUS HOME HEALTH CARE
- Incorporation date
- 2017-04-24
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 17620 SHERMAN WAY
- Address line 2
- STE 214
- City
- VAN NUYS
- State
- CA
- Zip code
- 914063527