- Enrollment id
- O20200421002963
- Enrollment state
- NV
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1689207649
- Multiple npi flag
- N
- Ccn
- 291577
- Associate id
- 1658701396
- Organization name
- SILVER STATE HOSPICE CARE LLC
- Doing business as name
- SIMITREE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 1771 E FLAMINGO RD
- Address line 2
- STE 120A
- City
- LAS VEGAS
- State
- NV
- Zip code
- 891190837