- Enrollment id
- O20220128000093
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1801403985
- Multiple npi flag
- N
- Ccn
- 753143
- Associate id
- 4880091842
- Organization name
- PRINCIPLE HOME HEALTH INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 9608 VAN NUYS BLVD
- Address line 2
- STE 204B
- City
- PANORAMA CITY
- State
- CA
- Zip code
- 914021043