- Enrollment id
- O20240702004384
- Enrollment state
- UT
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1639939978
- Multiple npi flag
- N
- Ccn
- 461514
- Associate id
- 6800330754
- Organization name
- GRANDVIEW HEALTHCARE LLC
- Doing business as name
- SYMBII DAVIS HOSPICE
- Incorporation date
- 2024-03-21
- Incorporation state
- UT
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 450 S 400 E
- Address line 2
- STE 727
- City
- BOUNTIFUL
- State
- UT
- Zip code
- 840104938