- Enrollment id
- O20220708000293
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1790367191
- Multiple npi flag
- N
- Ccn
- 757402
- Associate id
- 0840670832
- Organization name
- ELITE COMFORT HOME HEALTH CARE
- Incorporation date
- 2021-01-22
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 21405 DEVONSHIRE ST
- Address line 2
- STE 221
- City
- CHATSWORTH
- State
- CA
- Zip code
- 913112941