- Enrollment id
- O20211029000225
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1841892007
- Multiple npi flag
- N
- Ccn
- 757021
- Associate id
- 4981015476
- Organization name
- VILLA BLANCA HOME HEALTH INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 8949 RESEDA BLVD
- Address line 2
- STE 202
- City
- NORTHRIDGE
- State
- CA
- Zip code
- 913243966
- Practice location type
- HHA BRANCH