- Enrollment id
- O20040406001473
- Enrollment state
- AZ
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1588682405
- Multiple npi flag
- N
- Ccn
- 031500
- Associate id
- 4183617053
- Organization name
- HOSPICE OF THE VALLEY
- Doing business as name
- HOSPICE OF THE VALLEY - CENTRAL
- Incorporation date
- 1997-02-13
- Incorporation state
- AZ
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 1510 E FLOWER ST
- Address line 2
- BLDG 2
- City
- PHOENIX
- State
- AZ
- Zip code
- 850145656