- Enrollment id
- O20140401000029
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1699101816
- Multiple npi flag
- N
- Ccn
- 921657
- Associate id
- 2163653387
- Organization name
- VISITING ANGEL HOSPICE INC
- Doing business as name
- VISITING ANGEL HOSPICE
- Incorporation date
- 2013-09-03
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 539 N GLENOAKS BLVD
- Address line 2
- STE 307
- City
- BURBANK
- State
- CA
- Zip code
- 915023213