- Enrollment id
- O20220405000095
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1427636760
- Multiple npi flag
- N
- Ccn
- B51745
- Associate id
- 4688060411
- Organization name
- EXCEPTIONAL HOSPICE CARE
- Incorporation date
- 2021-03-18
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 818 N MOUNTAIN AVE
- Address line 2
- STE 103
- City
- UPLAND
- State
- CA
- Zip code
- 917864164