- Enrollment id
- O20230303000587
- Enrollment state
- NV
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1033848072
- Multiple npi flag
- N
- Ccn
- 291657
- Associate id
- 9537532023
- Organization name
- AMPLE CARE HOSPICE LLC
- Incorporation date
- 2021-10-12
- Incorporation state
- NV
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 3305 SPRING MOUNTAIN RD
- Address line 2
- STE 45
- City
- LAS VEGAS
- State
- NV
- Zip code
- 891028622