- Enrollment id
- O20050315000077
- Enrollment state
- FL
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1134126774
- Multiple npi flag
- N
- Ccn
- 101500
- Associate id
- 4688629454
- Organization name
- COMMUNITY HOSPICE OF NORTHEAST FLORIDA INC
- Doing business as name
- COMMUNITY HOSPICE OF N.E. FLORIDA
- Incorporation date
- 1978-11-27
- Incorporation state
- FL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 4266 SUNBEAM RD
- City
- JACKSONVILLE
- State
- FL
- Zip code
- 322572425