- Enrollment id
- O20200611001289
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1518509546
- Multiple npi flag
- N
- Ccn
- A11695
- Associate id
- 9234550625
- Organization name
- ANGELIC TOUCH HOSPICE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6931 VAN NUYS BLVD
- Address line 2
- STE 331H
- City
- VAN NUYS
- State
- CA
- Zip code
- 914053999