- Enrollment id
- O20220324000390
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1902412851
- Multiple npi flag
- N
- Ccn
- B51612
- Associate id
- 0244625556
- Organization name
- VERANDA HOSPICE & PALLIATIVE CARE INC
- Incorporation date
- 2020-07-16
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1220 W GLENOAKS BLVD
- Address line 2
- STE 204B
- City
- GLENDALE
- State
- CA
- Zip code
- 912012231