- Enrollment id
- O20221017001150
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1750908109
- Multiple npi flag
- N
- Ccn
- B51600
- Associate id
- 1052787058
- Organization name
- ALOE VERA HOSPICE LLC
- Incorporation date
- 2020-03-11
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 18345 VENTURA BLVD
- Address line 2
- STE 206
- City
- TARZANA
- State
- CA
- Zip code
- 913564241