- Enrollment id
- O20240312001241
- Enrollment state
- PA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1275232795
- Multiple npi flag
- N
- Ccn
- 391684
- Associate id
- 8527977735
- Organization name
- SOUTHERNCARE, INC.
- Doing business as name
- HEARTLAND HOSPICE (CHADDS FORD)
- Incorporation date
- 2002-12-30
- Incorporation state
- DE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 5 CHRISTY DR
- Address line 2
- STE 103
- City
- CHADDS FORD
- State
- PA
- Zip code
- 193179667