Public record

CMS Hospice Enrollments

Npi: 1366460289 · 1 matching record

Enrollment id
O20040406001686
Enrollment state
AZ
Provider type code
00-08
Provider type text
PART A PROVIDER - HOSPICE
Npi
1366460289
Multiple npi flag
N
Ccn
031505
Associate id
4183617053
Organization name
HOSPICE OF THE VALLEY
Incorporation date
1997-02-13
Incorporation state
AZ
Organization type structure
CORPORATION
Proprietary nonprofit
N
Address line 1
2020 E WOODSIDE CT
City
GILBERT
State
AZ
Zip code
852977339

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