- Enrollment id
- O20191217002560
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1801367461
- Multiple npi flag
- N
- Ccn
- 559306
- Associate id
- 9335573724
- Organization name
- ETHOS HOME HEALTH CARE
- Incorporation date
- 2018-10-23
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 150 E OLIVE AVE
- Address line 2
- STE 212
- City
- BURBANK
- State
- CA
- Zip code
- 915021850