- Enrollment id
- O20200708000031
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1265076277
- Multiple npi flag
- N
- Ccn
- B21575
- Associate id
- 4587087630
- Organization name
- CHERUB INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 9608 VAN NUYS BLVD
- Address line 2
- STE 202
- City
- PANORAMA CITY
- State
- CA
- Zip code
- 914021043