- Enrollment id
- O20160503001184
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1487059390
- Multiple npi flag
- N
- Ccn
- 921687
- Associate id
- 2062711625
- Organization name
- ELKA HOSPICE CARE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 11755 VICTORY BLVD
- Address line 2
- STE 213
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916063423