- Enrollment id
- O20121106000265
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1134476237
- Multiple npi flag
- N
- Ccn
- 751709
- Associate id
- 9234380940
- Organization name
- THE AMBIENT HOSPICE INC
- Incorporation date
- 2012-05-18
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6350 LAUREL CANYON BLVD
- Address line 2
- STE 330
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916063224