- Enrollment id
- O20181226000898
- Enrollment state
- CO
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1548738842
- Multiple npi flag
- N
- Ccn
- 061611
- Associate id
- 7719222504
- Organization name
- GRACIA HOSPICE GROUP, INC.
- Incorporation date
- 2016-01-05
- Incorporation state
- CO
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 7985 VANCE DR
- Address line 2
- STE 308
- City
- ARVADA
- State
- CO
- Zip code
- 800032120