- Enrollment id
- O20150123000614
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1700280328
- Multiple npi flag
- N
- Ccn
- A01502
- Associate id
- 8628392560
- Organization name
- ACHIEVA HOSPICE INC
- Doing business as name
- MISSION HOSPICE OF THE INLAND EMPIRE
- Incorporation date
- 2003-02-03
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 818 N MOUNTAIN AVE
- Address line 2
- STE 104
- City
- UPLAND
- State
- CA
- Zip code
- 917864164