- Enrollment id
- O20210325001515
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1184222630
- Multiple npi flag
- N
- Ccn
- B31505
- Associate id
- 1456768191
- Organization name
- GENTLE CARE HOSPICE SERVICES CORP
- Incorporation date
- 2020-10-01
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 490 S ROSEMEAD BLVD
- Address line 2
- STE 3
- City
- PASADENA
- State
- CA
- Zip code
- 911074958