- Enrollment id
- O20071112000565
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1942494281
- Multiple npi flag
- N
- Ccn
- 059325
- Associate id
- 8921196726
- Organization name
- MHIRAMARC MANAGEMENT LLC HOME HEALTH SERVICES
- Incorporation date
- 2010-02-19
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 19725 SHERMAN WAY
- Address line 2
- STE 125
- City
- WINNETKA
- State
- CA
- Zip code
- 91306