- Enrollment id
- O20210727000656
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1194327577
- Multiple npi flag
- N
- Ccn
- B51624
- Associate id
- 3678976701
- Organization name
- RELIACARE HOSPICE INC
- Doing business as name
- AMERICARE HOSPICE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 4119 W BURBANK BLVD
- Address line 2
- STE 145
- City
- BURBANK
- State
- CA
- Zip code
- 915052122