- Enrollment id
- O20121115000036
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1720334626
- Multiple npi flag
- N
- Ccn
- 551742
- Associate id
- 4486805702
- Organization name
- PRIORITY ONE HOSPICE, INC.
- Incorporation date
- 2012-08-11
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 4959 PALO VERDE ST
- Address line 2
- STE 107C
- City
- MONTCLAIR
- State
- CA
- Zip code
- 917632357