- Enrollment id
- O20180629001106
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1891170965
- Multiple npi flag
- N
- Ccn
- 559117
- Associate id
- 3577819846
- Organization name
- ST JOSEPH HOME HEALTH CARE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 353 E ANGELENO AVE
- Address line 2
- STE E
- City
- BURBANK
- State
- CA
- Zip code
- 915021310