- Enrollment id
- O20151117002041
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1710358320
- Multiple npi flag
- N
- Ccn
- 921730
- Associate id
- 2567772833
- Organization name
- UNITED HEARTS HOSPICE HEALTH SERVICES INC
- Incorporation date
- 2015-08-03
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 2139 TAPO ST
- Address line 2
- STE 219
- City
- SIMI VALLEY
- State
- CA
- Zip code
- 930633477