- Enrollment id
- O20231130001495
- Enrollment state
- PA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1700585221
- Multiple npi flag
- N
- Ccn
- 391610
- Associate id
- 8527977735
- Organization name
- SOUTHERNCARE, INC.
- Doing business as name
- HEARTLAND HOSPICE
- Incorporation date
- 2002-12-30
- Incorporation state
- DE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 750 HOLIDAY DR
- Address line 2
- STE 610 FOSTER PLAZA #9
- City
- PITTSBURGH
- State
- PA
- Zip code
- 152202769