- Enrollment id
- O20240129001728
- Enrollment state
- IL
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1629791728
- Multiple npi flag
- N
- Ccn
- 141739
- Associate id
- 9234582032
- Organization name
- CENTURION HOSPICE & PALLIATIVE CARE, INC
- Incorporation date
- 2022-08-30
- Incorporation state
- IL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 2720 S RIVER RD
- Address line 2
- STE 219
- City
- DES PLAINES
- State
- IL
- Zip code
- 600184111