- Enrollment id
- O20160208001291
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1982074738
- Multiple npi flag
- N
- Ccn
- 053182
- Associate id
- 5890099121
- Organization name
- CARE AND SUPPORT HOME HEALTH INC.
- Incorporation date
- 2016-01-02
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 43801 HALCOM AVE
- City
- LANCASTER
- State
- CA
- Zip code
- 935365819