- Enrollment id
- O20211014001338
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1952892861
- Multiple npi flag
- N
- Ccn
- 753141
- Associate id
- 1052668522
- Organization name
- K.K.A. HOME HEALTH CARE INC
- Incorporation date
- 2018-02-05
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 8925 SEPULVEDA BLVD
- Address line 2
- UNIT 213
- City
- NORTH HILLS
- State
- CA
- Zip code
- 913434354