- Enrollment id
- O20220331001547
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1447763925
- Multiple npi flag
- N
- Ccn
- D61547
- Associate id
- 8628464682
- Organization name
- LOVING RAINBOW HOSPICE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 315 ARDEN AVE
- Address line 2
- STE 4
- City
- GLENDALE
- State
- CA
- Zip code
- 912031165