- Enrollment id
- O20220427003189
- Enrollment state
- FL
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1407527849
- Multiple npi flag
- N
- Ccn
- 101566
- Associate id
- 8022405737
- Organization name
- MOMENTS HOSPICE OF MIAMI LLC
- Incorporation date
- 2021-02-17
- Incorporation state
- FL
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 7850 NW 146TH ST
- Address line 2
- STE 508
- City
- MIAMI LAKES
- State
- FL
- Zip code
- 330161516