- Enrollment id
- O20210806000536
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1114514726
- Multiple npi flag
- N
- Ccn
- B51710
- Associate id
- 2163826520
- Organization name
- A TOUCH OF ANGEL HOSPICE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 664 W BROADWAY
- Address line 2
- STE I
- City
- GLENDALE
- State
- CA
- Zip code
- 912041097