- Enrollment id
- O20200819002971
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1104436955
- Multiple npi flag
- N
- Ccn
- A11693
- Associate id
- 4486070547
- Organization name
- MD CARE HOSPICE
- Incorporation date
- 2020-07-21
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 303 N GLENOAKS BLVD
- Address line 2
- STE 207
- City
- BURBANK
- State
- CA
- Zip code
- 915021116