- Enrollment id
- O20200903003572
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1245860592
- Multiple npi flag
- N
- Ccn
- B21513
- Associate id
- 6406273416
- Organization name
- G AND G HOSPICE CARE INC
- Incorporation date
- 2019-10-10
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 10523 BURBANK BLVD
- Address line 2
- STE 119
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916012233