- Enrollment id
- O20240822001420
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1962139576
- Multiple npi flag
- N
- Ccn
- 757827
- Associate id
- 9638618671
- Organization name
- SHELDON HOME HEALTH INC
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14640 VICTORY BLVD
- Address line 2
- STE 204B
- City
- VAN NUYS
- State
- CA
- Zip code
- 914111623