- Enrollment id
- O20131230000638
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1427482710
- Multiple npi flag
- N
- Ccn
- 751628
- Associate id
- 9032346770
- Organization name
- CB HOMECARE HOSPICE CORPORATION
- Incorporation date
- 2010-12-06
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 512 E WILSON AVE
- Address line 2
- STE 204
- City
- GLENDALE
- State
- CA
- Zip code
- 912064351