- Enrollment id
- O20140505001688
- Enrollment state
- NV
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1073925533
- Multiple npi flag
- N
- Ccn
- 291546
- Associate id
- 1254564982
- Organization name
- GALAXY HOSPICE INC
- Incorporation date
- 2013-05-20
- Incorporation state
- NV
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 4055 SPENCER ST
- Address line 2
- STE 217
- City
- LAS VEGAS
- State
- NV
- Zip code
- 891195251