- Enrollment id
- O20210727000600
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1881216885
- Multiple npi flag
- N
- Ccn
- B21762
- Associate id
- 6507269636
- Organization name
- BRIGHTSTAR HOSPICE INC
- Incorporation date
- 2020-04-01
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 120 N VICTORY BLVD
- Address line 2
- STE 304
- City
- BURBANK
- State
- CA
- Zip code
- 915020001