- Enrollment id
- O20201124002311
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1659996106
- Multiple npi flag
- N
- Ccn
- B31548
- Associate id
- 8224449160
- Organization name
- REPOSE HOSPICE CARE INC
- Incorporation date
- 2020-05-17
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 22024 LASSEN ST
- Address line 2
- STE 109
- City
- CHATSWORTH
- State
- CA
- Zip code
- 913113600