- Enrollment id
- O20240319003074
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1538785720
- Multiple npi flag
- N
- Ccn
- D61535
- Associate id
- 1254789365
- Organization name
- SOLACE HOSPICE CARE, INC.
- Incorporation date
- 2020-03-23
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 121 W LEXINGTON DR
- Address line 2
- STE 511
- City
- GLENDALE
- State
- CA
- Zip code
- 912032230