- Enrollment id
- O20220103000768
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1093393415
- Multiple npi flag
- N
- Ccn
- B41782
- Associate id
- 6901297845
- Organization name
- GO NORTH HOSPICE CARE INC
- Doing business as name
- EL MED HOSPICE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 9221 CORBIN AVE
- Address line 2
- STE 205
- City
- NORTHRIDGE
- State
- CA
- Zip code
- 913242483