- Enrollment id
- O20211021000916
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1326641093
- Multiple npi flag
- N
- Ccn
- B51661
- Associate id
- 4880082049
- Organization name
- VALLEY STAR HOSPICE INC
- Incorporation date
- 2020-11-04
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 440 W COLORADO ST
- Address line 2
- STE 102
- City
- GLENDALE
- State
- CA
- Zip code
- 912044812