- Enrollment id
- O20210224002491
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1407463763
- Multiple npi flag
- N
- Ccn
- B41567
- Associate id
- 0840605887
- Organization name
- MAR HOSPICE CARE
- Incorporation date
- 2020-07-17
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5530 CORBIN AVE
- Address line 2
- STE 205
- City
- TARZANA
- State
- CA
- Zip code
- 913567133