- Enrollment id
- O20211223001121
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1366082349
- Multiple npi flag
- N
- Ccn
- B41734
- Associate id
- 1153712369
- Organization name
- AGAPE HOSPICE CARE, INC.
- Incorporation date
- 2019-09-16
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5924 E LOS ANGELES AVE
- Address line 2
- STE L
- City
- SIMI VALLEY
- State
- CA
- Zip code
- 930635526