- Enrollment id
- O20220310002095
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1093316739
- Multiple npi flag
- N
- Ccn
- B51686
- Associate id
- 5890180780
- Organization name
- S AND N HOSPICE INC
- Incorporation date
- 2022-05-02
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 2500 E FOOTHILL BLVD
- Address line 2
- STE 512
- City
- PASADENA
- State
- CA
- Zip code
- 911077126