- Enrollment id
- O20200212000036
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1821509555
- Multiple npi flag
- N
- Ccn
- 559392
- Associate id
- 8022444033
- Organization name
- HARVARD HOME HEALTH LLC
- Incorporation date
- 2017-10-09
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 511 E HARVARD ST
- Address line 2
- STE 6
- City
- GLENDALE
- State
- CA
- Zip code
- 912051184