- Enrollment id
- O20220315002396
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1699365684
- Multiple npi flag
- N
- Ccn
- B51779
- Associate id
- 6406241173
- Organization name
- BEGINNING LIFE HOSPICE INC
- Incorporation date
- 2020-12-23
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 17620 SHERMAN WAY
- Address line 2
- STE 213
- City
- VAN NUYS
- State
- CA
- Zip code
- 914063527