- Enrollment id
- O20151123001268
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1063896835
- Multiple npi flag
- N
- Ccn
- 921745
- Associate id
- 8325348485
- Organization name
- AMERICUS HOSPICE INC
- Incorporation date
- 2015-04-20
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5924 E LOS ANGELES AVENUE
- Address line 2
- STE T
- City
- SIMI VALLEY
- State
- CA
- Zip code
- 930635526