- Enrollment id
- O20220309002571
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1497351217
- Multiple npi flag
- N
- Ccn
- B41566
- Associate id
- 7012302045
- Organization name
- COLLECTIVE HOSPICE CARE INC
- Incorporation date
- 2020-11-04
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14547 TITUS ST
- Address line 2
- STE 215
- City
- PANORAMA CITY
- State
- CA
- Zip code
- 914024936