- Enrollment id
- O20200528002040
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1962964502
- Multiple npi flag
- N
- Ccn
- 559402
- Associate id
- 6002237153
- Organization name
- DIRECT CARE HOME HEALTH INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 232 N LAKE AVE
- Address line 2
- STE 212
- City
- PASADENA
- State
- CA
- Zip code
- 911014152