- Enrollment id
- O20200730001632
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1942828496
- Multiple npi flag
- N
- Ccn
- B21731
- Associate id
- 9436574092
- Organization name
- DEVOTED HEALTH HOSPICE
- Incorporation date
- 2020-07-03
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 8925 SEPULVEDA BLVD
- Address line 2
- STE 204D
- City
- NORTH HILLS
- State
- CA
- Zip code
- 913434354