- Enrollment id
- O20201028002975
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1861004673
- Multiple npi flag
- N
- Ccn
- D61523
- Associate id
- 7012327208
- Organization name
- ELEVATE HOSPICE CARE INC
- Incorporation date
- 2020-07-07
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 14545 FRIAR ST
- Address line 2
- STE 139
- City
- VAN NUYS
- State
- CA
- Zip code
- 914112397