- Enrollment id
- O20210719003006
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1821606096
- Multiple npi flag
- N
- Ccn
- 559642
- Associate id
- 5890100465
- Organization name
- 1ST FAMILY HOME HEALTH INC
- Incorporation date
- 2020-05-18
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14621 TITUS ST
- Address line 2
- STE 132
- City
- PANORAMA CITY
- State
- CA
- Zip code
- 914024969