- Enrollment id
- O20150721002359
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1902295686
- Multiple npi flag
- N
- Ccn
- 053166
- Associate id
- 3173836053
- Organization name
- VISTA HOME HEALTH CARE INC
- Incorporation date
- 2014-01-20
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 7200 VINELAND AVE
- Address line 2
- UNIT 204B
- City
- SUN VALLEY
- State
- CA
- Zip code
- 913525089
- Practice location type
- HHA BRANCH