- Enrollment id
- O20170815000000
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1598316606
- Multiple npi flag
- N
- Ccn
- 551617
- Associate id
- 7416229240
- Organization name
- ATLANTIC CARE HOSPICE, INC.
- Incorporation date
- 2017-06-30
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12444 VICTORY BLVD
- Address line 2
- STE 303
- City
- NORTH HOLLYWOOD
- State
- CA
- Zip code
- 916063199