- Enrollment id
- O20210729001801
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1407400351
- Multiple npi flag
- N
- Ccn
- A11619
- Associate id
- 0042549537
- Organization name
- SILVER SKY HOSPICE INC
- Incorporation date
- 2019-05-23
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 20121 VENTURA BLVD
- Address line 2
- STE 309
- City
- WOODLAND HILLS
- State
- CA
- Zip code
- 913642559