- Enrollment id
- O20151117001400
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1487025458
- Multiple npi flag
- N
- Ccn
- A01546
- Associate id
- 1153631403
- Organization name
- FAITHFUL HOSPICE CARE INC
- Incorporation date
- 2017-01-19
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5924 E LOS ANGELES AVE
- Address line 2
- STE F
- City
- SIMI VALLEY
- State
- CA
- Zip code
- 930635526