- Enrollment id
- O20230403000051
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1861159709
- Multiple npi flag
- N
- Ccn
- 757684
- Associate id
- 9436524600
- Organization name
- LH HOME CARE SERVICE INC
- Incorporation date
- 2021-10-27
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 520 E WILSON AVE
- Address line 2
- STE 240
- City
- GLENDALE
- State
- CA
- Zip code
- 912064350