- Enrollment id
- O20240723000328
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1982351417
- Multiple npi flag
- N
- Ccn
- 757911
- Associate id
- 8022554476
- Organization name
- EL PRIMERO HOME HEALTH CARE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 7335 VAN NUYS BLVD
- Address line 2
- STE 223
- City
- VAN NUYS
- State
- CA
- Zip code
- 914051998