- Enrollment id
- O20210302002592
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1720683253
- Multiple npi flag
- N
- Ccn
- B41756
- Associate id
- 7810303625
- Organization name
- ROSE GARDEN HOSPICE INC
- Incorporation date
- 2020-11-13
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 3171 LOS FELIZ BLVD
- Address line 2
- STE 311A
- City
- LOS ANGELES
- State
- CA
- Zip code
- 900391537