- Enrollment id
- O20121130000385
- Enrollment state
- IL
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1285907303
- Multiple npi flag
- N
- Ccn
- 141652
- Associate id
- 6406008234
- Organization name
- SOLACE HOSPICE & PALLIATIVE CARE INC
- Incorporation date
- 2012-02-10
- Incorporation state
- IL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 40W310 LAFOX RD
- Address line 2
- UNIT K2
- City
- ST CHARLES
- State
- IL
- Zip code
- 601756588