- Enrollment id
- O20200505000961
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1235767575
- Multiple npi flag
- N
- Ccn
- A11787
- Associate id
- 6002247194
- Organization name
- AFFINITY HOSPICE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 120 N VICTORY BLVD
- Address line 2
- STE 104
- City
- BURBANK
- State
- CA
- Zip code
- 915021836