- Enrollment id
- O20211116001301
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1811593114
- Multiple npi flag
- N
- Ccn
- 753121
- Associate id
- 7517356348
- Organization name
- ARROWHEAD HOME INC
- Incorporation date
- 2020-12-01
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 639 S GLENWOOD PL
- Address line 2
- UNIT 118
- City
- BURBANK
- State
- CA
- Zip code
- 915062819