- Enrollment id
- O20070827000951
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1831380229
- Multiple npi flag
- N
- Ccn
- 059255
- Associate id
- 7214029875
- Organization name
- OPTIMA HEALTH CARE SERVICES INC.
- Incorporation date
- 2005-12-05
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 235E BROADWAY 920
- City
- LONG BEACH
- State
- CA
- Zip code
- 908024843