- Enrollment id
- O20231218002398
- Enrollment state
- UT
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1497720080
- Multiple npi flag
- N
- Ccn
- 461542
- Associate id
- 8921457888
- Organization name
- REFINED HOSPICE LLC
- Incorporation date
- 2023-10-10
- Incorporation state
- UT
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 623 E FORT UNION BLVD
- Address line 2
- STE 105
- City
- MIDVALE
- State
- UT
- Zip code
- 840475529