- Enrollment id
- O20210701002438
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1205440369
- Multiple npi flag
- N
- Ccn
- B31640
- Associate id
- 1850792532
- Organization name
- CITYWIDE HOSPICE CARE INC
- Incorporation date
- 2019-08-13
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 7590 N GLENOAKS BLVD
- Address line 2
- STE 103
- City
- BURBANK
- State
- CA
- Zip code
- 915041011