- Enrollment id
- O20221213001484
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1982271490
- Multiple npi flag
- N
- Ccn
- 757293
- Associate id
- 1254700388
- Organization name
- WHITE STAR HOME HEALTH, INC.
- Incorporation date
- 2021-04-23
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 4444 W RIVERSIDE DR
- Address line 2
- STE 204A
- City
- BURBANK
- State
- CA
- Zip code
- 915054048