- Enrollment id
- O20200805003444
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1912478645
- Multiple npi flag
- N
- Ccn
- 757093
- Associate id
- 8729403860
- Organization name
- VERITAS HOME HEALTH CARE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 502 W ROUTE 66
- Address line 2
- STE 18B
- City
- GLENDORA
- State
- CA
- Zip code
- 917404343