- Enrollment id
- O20250708003940
- Enrollment state
- KS
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1275190282
- Multiple npi flag
- N
- Ccn
- 171632
- Associate id
- 1557875960
- Organization name
- OURKANSAS GUARDIAN HOSPICE LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 9415 E HARRY ST
- Address line 2
- STE 606
- City
- WICHITA
- State
- KS
- Zip code
- 672075082