- Enrollment id
- O20040406001730
- Enrollment state
- AZ
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1043238975
- Multiple npi flag
- N
- Ccn
- 031515
- Associate id
- 4183617053
- Organization name
- HOSPICE OF THE VALLEY
- Incorporation date
- 1997-02-13
- Incorporation state
- AZ
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 9435 W PEORIA AVE
- City
- PEORIA
- State
- AZ
- Zip code
- 853456479