- Enrollment id
- O20221116000090
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1881362911
- Multiple npi flag
- N
- Ccn
- 757382
- Associate id
- 9537537931
- Organization name
- SUNNY SMILE HOME HEALTH, INC
- Incorporation date
- 2021-08-26
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 22151 VENTURA BLVD
- Address line 2
- STE 207
- City
- WOODLAND HILLS
- State
- CA
- Zip code
- 913641665