- Enrollment id
- O20220825000849
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1801465307
- Multiple npi flag
- N
- Ccn
- 757230
- Associate id
- 5395129332
- Organization name
- SPEEDY CARE HOME HEALTH INC
- Incorporation date
- 2021-04-23
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14664 VICTORY BLVD
- Address line 2
- STE 110
- City
- VAN NUYS
- State
- CA
- Zip code
- 914111621