- Enrollment id
- O20231121000724
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1902486129
- Multiple npi flag
- N
- Ccn
- 757582
- Associate id
- 5496125403
- Organization name
- NOBLE HOME HEALTHCARE SYSTEMS, INC.
- Incorporation date
- 2021-04-05
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 4730 WOODMAN AVE
- Address line 2
- # 420
- City
- SHERMAN OAKS
- State
- CA
- Zip code
- 914232400