- Enrollment id
- O20230309000786
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1942801840
- Multiple npi flag
- N
- Ccn
- 757524
- Associate id
- 0941673123
- Organization name
- INTEGRATED HOME HEALTH CARE INC
- Incorporation date
- 2020-10-19
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12444 VICTORY BLVD
- Address line 2
- STE 400
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916063156
- Practice location type
- HHA BRANCH