- Enrollment id
- O20200421001825
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1811547383
- Multiple npi flag
- N
- Ccn
- A11680
- Associate id
- 9133557481
- Organization name
- VERONA HOSPICE INC
- Incorporation date
- 2019-08-22
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 9608 VAN NUYS BLVD
- Address line 2
- STE 204A
- City
- PANORAMA CITY
- State
- CA
- Zip code
- 914021043