- Enrollment id
- O20211008001537
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1689275430
- Multiple npi flag
- N
- Ccn
- B31659
- Associate id
- 2062810872
- Organization name
- PRO-CHOICE HOSPICE INC
- Incorporation date
- 2020-10-28
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 19634 VENTURA BLVD
- Address line 2
- STE 302
- City
- TARZANA
- State
- CA
- Zip code
- 913567140