- Enrollment id
- O20160519000096
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1154785004
- Multiple npi flag
- N
- Ccn
- 921569
- Associate id
- 4789973439
- Organization name
- THOUSAND OAKS HOSPICE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 17050 CHATSWORTH ST
- Address line 2
- STE 235
- City
- GRANADA HILLS
- State
- CA
- Zip code
- 913445898