- Enrollment id
- O20210820000246
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1871179937
- Multiple npi flag
- N
- Ccn
- B41662
- Associate id
- 5799180329
- Organization name
- CROWN HOSPICE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 3111 LOS FELIZ BLVD
- Address line 2
- STE 218
- City
- LOS ANGELES
- State
- CA
- Zip code
- 900391585