- Enrollment id
- O20201228001866
- Enrollment state
- NE
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1245832617
- Multiple npi flag
- N
- Ccn
- 281546
- Associate id
- 9739592353
- Organization name
- TRADITIONS HOSPICE OF LINCOLN LLC
- Doing business as name
- ST CROIX HOSPICE
- Incorporation date
- 2020-07-01
- Incorporation state
- DE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 300 S 68TH STREET PL
- Address line 2
- STE 205
- City
- LINCOLN
- State
- NE
- Zip code
- 685102450