- Enrollment id
- O20090202000224
- Enrollment state
- OH
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1275735052
- Multiple npi flag
- N
- Ccn
- 361645
- Associate id
- 9739243031
- Organization name
- GENERATION HOSPICE LLC
- Incorporation date
- 2007-04-12
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 26 N WESTMOOR AVE
- City
- NEWARK
- State
- OH
- Zip code
- 430551840