- Enrollment id
- O20210902000104
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1851921373
- Multiple npi flag
- N
- Ccn
- 757081
- Associate id
- 5890191688
- Organization name
- INTEGRAL HOME HEALTH CARE INC
- Incorporation date
- 2019-06-17
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14547 TITUS ST
- Address line 2
- STE 203
- City
- PANORAMA CITY
- State
- CA
- Zip code
- 914024924