- Enrollment id
- O20160211000579
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1609288851
- Multiple npi flag
- N
- Ccn
- A11580
- Associate id
- 6406150440
- Organization name
- SAINT LUCY INC
- Doing business as name
- SAINT LUCY HOSPICE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 3111 LOS FELIZ BLVD
- Address line 2
- UNIT 103
- City
- LOS ANGELES
- State
- CA
- Zip code
- 900391599