- Enrollment id
- O20200925001293
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1972117158
- Multiple npi flag
- N
- Ccn
- B21629
- Associate id
- 2466871348
- Organization name
- USA VALLEY HOSPICE INC
- Incorporation date
- 2020-08-20
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12501 CHANDLER BLVD
- Address line 2
- STE 106
- City
- VALLEY VILLAGE
- State
- CA
- Zip code
- 916071954