- Enrollment id
- O20221214001326
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1346882610
- Multiple npi flag
- N
- Ccn
- B51785
- Associate id
- 7719398916
- Organization name
- ANGEL CARE HOSPICE LLC
- Incorporation date
- 2019-09-11
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 4100 W ALAMEDA AVE
- Address line 2
- STE 385
- City
- BURBANK
- State
- CA
- Zip code
- 915054195