- Enrollment id
- O20200625002667
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1972130169
- Multiple npi flag
- N
- Ccn
- B21578
- Associate id
- 6002238797
- Organization name
- ADVANCED CARE HOSPICE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 6931 VAN NUYS BLVD
- Address line 2
- STE 315-1
- City
- VAN NUYS
- State
- CA
- Zip code
- 914053937