- Enrollment id
- O20090806000451
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1790912871
- Multiple npi flag
- N
- Ccn
- 059399
- Associate id
- 4880747922
- Organization name
- SIGNATURE HOME HEALTH CARE INC
- Incorporation date
- 2009-06-12
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 9595 WILSHIRE BLVD
- Address line 2
- STE 205
- City
- BEVERLY HILLS
- State
- CA
- Zip code
- 902122502