- Enrollment id
- O20201014000934
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1023625035
- Multiple npi flag
- N
- Ccn
- B21711
- Associate id
- 9335569292
- Organization name
- K AND S HOSPICE INC
- Incorporation date
- 2020-09-18
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 4100 W ALAMEDA AVE
- Address line 2
- FL 3
- City
- BURBANK
- State
- CA
- Zip code
- 915054191