- Enrollment id
- O20210201001057
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1881284883
- Multiple npi flag
- N
- Ccn
- B31677
- Associate id
- 0749694800
- Organization name
- COMFORTCARE HOSPICE INC
- Incorporation date
- 2020-12-09
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 401 N BRAND BLVD
- Address line 2
- STE 822
- City
- GLENDALE
- State
- CA
- Zip code
- 912034427