- Enrollment id
- O20220303001081
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1205422466
- Multiple npi flag
- N
- Ccn
- B51662
- Associate id
- 5092109223
- Organization name
- AYAS HOSPICE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14328 VICTORY BLVD
- Address line 2
- STE G
- City
- VAN NUYS
- State
- CA
- Zip code
- 914016505