- Enrollment id
- O20210420001002
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1982247235
- Multiple npi flag
- N
- Ccn
- 757148
- Associate id
- 8628486289
- Organization name
- GHC SERVICES INC
- Incorporation date
- 2019-09-05
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 126 S JACKSON ST
- Address line 2
- STE 302
- City
- GLENDALE
- State
- CA
- Zip code
- 912054921