- Enrollment id
- O20240429001582
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1871254466
- Multiple npi flag
- N
- Ccn
- 757786
- Associate id
- 9739529439
- Organization name
- RADIANT HOME HEALTH CARE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 4100 W ALAMEDA AVE
- Address line 2
- STE 389
- City
- BURBANK
- State
- CA
- Zip code
- 915054195