- Enrollment id
- O20210806001133
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1538776984
- Multiple npi flag
- N
- Ccn
- D61503
- Associate id
- 1658775028
- Organization name
- HOUSE OF FAITH HOSPICE CARE INC
- Incorporation date
- 2020-09-16
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 9221 CORBIN AVE
- Address line 2
- STE 245A
- City
- NORTHRIDGE
- State
- CA
- Zip code
- 913242483