- Enrollment id
- O20120424000561
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1194097741
- Multiple npi flag
- N
- Ccn
- 751501
- Associate id
- 4385806132
- Organization name
- INTEGRITY CARE OF THE WEST, INC.
- Doing business as name
- SACRED LIFE HOSPICE
- Incorporation date
- 2011-11-09
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 15130 VENTURA BLVD
- Address line 2
- STE 304
- City
- SHERMAN OAKS
- State
- CA
- Zip code
- 914033378