- Enrollment id
- O20240315002953
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1912651621
- Multiple npi flag
- N
- Ccn
- 757799
- Associate id
- 5597101246
- Organization name
- HEALTH HUB HOME HEALTH INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 15130 VENTURA BLVD
- Address line 2
- STE 307
- City
- SHERMAN OAKS
- State
- CA
- Zip code
- 914033378