- Enrollment id
- O20201209000782
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1457959884
- Multiple npi flag
- N
- Ccn
- D61524
- Associate id
- 6305258724
- Organization name
- CANESTRO CARE HOSPICE INC
- Incorporation date
- 2020-09-23
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 7335 VAN NUYS BLVD
- Address line 2
- UNIT 226
- City
- VAN NUYS
- State
- CA
- Zip code
- 914051998