- Enrollment id
- O20210826000481
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1558947606
- Multiple npi flag
- N
- Ccn
- B41614
- Associate id
- 9436554607
- Organization name
- ATHENA HOSPICE, INC.
- Incorporation date
- 2021-03-15
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 18401 BURBANK BLVD
- Address line 2
- STE 216
- City
- TARZANA
- State
- CA
- Zip code
- 913562822