- Enrollment id
- O20210714003288
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1780132266
- Multiple npi flag
- N
- Ccn
- A11615
- Associate id
- 8628470598
- Organization name
- MERIDIAN HOSPICE INC
- Incorporation date
- 2016-02-23
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 4312 WOODMAN AVE
- Address line 2
- STE 302
- City
- SHERMAN OAKS
- State
- CA
- Zip code
- 914235528