- Enrollment id
- O20191121001198
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1871141416
- Multiple npi flag
- N
- Ccn
- B51671
- Associate id
- 4981036431
- Organization name
- RED LINE HOSPICE, INC.
- Incorporation date
- 2019-07-15
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 13746 VICTORY BLVD
- Address line 2
- STE 202
- City
- VAN NUYS
- State
- CA
- Zip code
- 914016717