- Enrollment id
- O20240726002883
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1881367936
- Multiple npi flag
- N
- Ccn
- 758102
- Associate id
- 6406222934
- Organization name
- BRIDGE HOME HEALTH INC
- Incorporation date
- 2021-04-07
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12444 VICTORY BLVD
- Address line 2
- STE 301-W
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916063199