- Enrollment id
- O20250609000839
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1083235949
- Multiple npi flag
- N
- Ccn
- D61563
- Associate id
- 5193235299
- Organization name
- ST LUKES HOSPICE AND PALLIATIVE CARE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 224 E OLIVE AVE
- Address line 2
- STE 207
- City
- BURBANK
- State
- CA
- Zip code
- 915021234