- Enrollment id
- O20031023000013
- Enrollment state
- MO
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1609885136
- Multiple npi flag
- N
- Ccn
- 261596
- Associate id
- 3173435930
- Organization name
- GRACE HOSPICE LLC
- Doing business as name
- ELARA CARING
- Incorporation date
- 2003-07-07
- Incorporation state
- MO
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 4200 LITTLE BLUE PKWY
- Address line 2
- STE 530
- City
- INDEPENDENCE
- State
- MO
- Zip code
- 640578312