- Enrollment id
- O20111231000006
- Enrollment state
- LA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1215928551
- Multiple npi flag
- N
- Ccn
- 191547
- Associate id
- 4688840226
- Organization name
- FAITH FOUNDATION HOSPICE
- Incorporation date
- 2002-02-14
- Incorporation state
- LA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 3503 PARLIAMENT CT
- City
- ALEXANDRIA
- State
- LA
- Zip code
- 713033135