- Enrollment id
- O20161018000050
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1891142147
- Multiple npi flag
- N
- Ccn
- 559008
- Associate id
- 8325336746
- Organization name
- BLOOMING HOME HEALTH CARE INC
- Incorporation date
- 2016-03-14
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 10523 BURBANK BLVD
- Address line 2
- STE 205
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916012238