- Enrollment id
- O20210113001090
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1386263622
- Multiple npi flag
- N
- Ccn
- B21687
- Associate id
- 3971916891
- Organization name
- PSL HOSPICE CARE INC
- Incorporation date
- 2019-05-17
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14545 FRIAR ST
- Address line 2
- STE 202U
- City
- VAN NUYS
- State
- CA
- Zip code
- 914112398