- Enrollment id
- O20211025002507
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1073125761
- Multiple npi flag
- N
- Ccn
- B41664
- Associate id
- 4284022211
- Organization name
- JOURNEY PALLIATIVE AND HOSPICE INC.
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 4405 W RIVERSIDE DR
- Address line 2
- STE 204
- City
- BURBANK
- State
- CA
- Zip code
- 915054050