- Enrollment id
- O20200818001463
- Enrollment state
- MI
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1568086056
- Multiple npi flag
- N
- Ccn
- 231686
- Associate id
- 9739505058
- Organization name
- JOHN PAUL HOME HOSPICE LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 30800 TELEGRAPH RD
- Address line 2
- STE 3700
- City
- BINGHAM FARMS
- State
- MI
- Zip code
- 480254583