- Enrollment id
- O20101101000055
- Enrollment state
- MS
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1609183292
- Multiple npi flag
- N
- Ccn
- 251669
- Associate id
- 3375737646
- Organization name
- SPECIALTY HOSPICE,LLC
- Doing business as name
- SPECIALTY HOSPICE
- Incorporation date
- 2010-03-01
- Incorporation state
- MS
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 5924 PLEASANT HILL RD
- City
- OLIVE BRANCH
- State
- MS
- Zip code
- 386545403