- Enrollment id
- O20210614002650
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1568088086
- Multiple npi flag
- N
- Ccn
- B21723
- Associate id
- 1951701895
- Organization name
- PALERMO HOSPICE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 229 N CENTRAL AVE
- Address line 2
- STE 201
- City
- GLENDALE
- State
- CA
- Zip code
- 912033554