- Enrollment id
- O20211007001021
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1356965511
- Multiple npi flag
- N
- Ccn
- B51719
- Associate id
- 4486052305
- Organization name
- PANAKEIA HOSPICE INC
- Incorporation date
- 2019-06-10
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5301 LAUREL CANYON BLVD
- Address line 2
- STE 101
- City
- VALLEY VILLAGE
- State
- CA
- Zip code
- 916072736