- Enrollment id
- O20240221003479
- Enrollment state
- MO
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1326811563
- Multiple npi flag
- N
- Ccn
- 261709
- Associate id
- 7810331527
- Organization name
- DOVER HOSPICE MO STL METRO, LLC
- Incorporation date
- 2023-10-23
- Incorporation state
- MO
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 300 HUNTER AVE
- Address line 2
- STE 107
- City
- SAINT LOUIS
- State
- MO
- Zip code
- 631242081