- Enrollment id
- O20040526000523
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1992831176
- Multiple npi flag
- N
- Ccn
- 058387
- Associate id
- 9335120328
- Organization name
- R&A HOME HEALTH SERVICES INC.
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 600 W BROADWAY
- Address line 2
- STE 210
- City
- GLENDALE
- State
- CA
- Zip code
- 912041024