- Enrollment id
- O20210920003075
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1093326795
- Multiple npi flag
- N
- Ccn
- B51642
- Associate id
- 3678970597
- Organization name
- DIRECT HOSPICE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 9003 RESEDA BLVD
- Address line 2
- STE 103
- City
- NORTHRIDGE
- State
- CA
- Zip code
- 913243939