- Enrollment id
- O20200930001517
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1003421090
- Multiple npi flag
- N
- Ccn
- B21660
- Associate id
- 5991124620
- Organization name
- PERENNIAL HOSPICE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 2501 W BURBANK BLVD
- Address line 2
- STE 311
- City
- BURBANK
- State
- CA
- Zip code
- 915052347