- Enrollment id
- O20210414002385
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1114511201
- Multiple npi flag
- N
- Ccn
- B41580
- Associate id
- 7810305760
- Organization name
- LION HEART HOSPICE INC
- Incorporation date
- 2021-01-18
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 8949 RESEDA BLVD
- Address line 2
- STE 227
- City
- NORTHRIDGE
- State
- CA
- Zip code
- 913245809