- Enrollment id
- O20210212000823
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1366032369
- Multiple npi flag
- N
- Ccn
- B41586
- Associate id
- 7012322647
- Organization name
- CRISIS HOSPICE AND PALLIATIVE CARE INC
- Incorporation date
- 2020-12-18
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6819 SEPULVEDA BLVD
- Address line 2
- STE 101
- City
- VAN NUYS
- State
- CA
- Zip code
- 914054464