- Enrollment id
- O20150203001705
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1669878989
- Multiple npi flag
- N
- Ccn
- B41715
- Associate id
- 6002131687
- Organization name
- ENCINO HOSPICE CARE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 16250 VENTURA BLVD
- Address line 2
- STE 415
- City
- ENCINO
- State
- CA
- Zip code
- 914364609