- Enrollment id
- O20160622000046
- Enrollment state
- MI
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1588019319
- Multiple npi flag
- N
- Ccn
- 231656
- Associate id
- 9638089972
- Organization name
- THE MEDICAL TEAM, INC.
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 400 ANN ST NW
- Address line 2
- STE 104
- City
- GRAND RAPIDS
- State
- MI
- Zip code
- 495042053