- Enrollment id
- O20200702001252
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1811510548
- Multiple npi flag
- N
- Ccn
- 559439
- Associate id
- 4981027356
- Organization name
- NCM CARE HOME HEALTH
- Incorporation date
- 2020-04-30
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 303 N GLENOAKS BLVD
- Address line 2
- STE 225
- City
- BURBANK
- State
- CA
- Zip code
- 915021116