- Enrollment id
- O20181205000074
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1982142170
- Multiple npi flag
- N
- Ccn
- A01592
- Associate id
- 1850635608
- Organization name
- EMERALD GARDENS HOSPICE, INC
- Doing business as name
- BUTTERFLY HOSPICE
- Incorporation date
- 2017-01-04
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 600 N MOUNTAIN AVE
- Address line 2
- STE C206
- City
- UPLAND
- State
- CA
- Zip code
- 917864367