- Enrollment id
- O20220505000793
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1063002590
- Multiple npi flag
- N
- Ccn
- B51505
- Associate id
- 2062809320
- Organization name
- FIRST RELIABLE HOSPICE CARE INC
- Incorporation date
- 2020-10-08
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 16501 SHERMAN WAY
- Address line 2
- STE 105A
- City
- VAN NUYS
- State
- CA
- Zip code
- 914063757