- Enrollment id
- O20071119000712
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1942496906
- Multiple npi flag
- N
- Ccn
- 059140
- Associate id
- 6709974025
- Organization name
- MED CARE INC
- Incorporation date
- 2007-08-01
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12722 RIVERSIDE DR
- Address line 2
- STE 101
- City
- VALLEY VILLAGE
- State
- CA
- Zip code
- 916073357