- Enrollment id
- O20220126001049
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1043806201
- Multiple npi flag
- N
- Ccn
- B51502
- Associate id
- 0648662577
- Organization name
- OPTIMAL CARE HOSPICE INC
- Incorporation date
- 2020-08-27
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 18340 VENTURA BLVD
- Address line 2
- STE 225
- City
- TARZANA
- State
- CA
- Zip code
- 913564278