- Enrollment id
- O20040722000707
- Enrollment state
- NY
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1770669038
- Multiple npi flag
- N
- Ccn
- 331529
- Associate id
- 4789664509
- Organization name
- MJHS HOSPICE AND PALLIATIVE CARE INC
- Doing business as name
- MJHS HOSPICE AND PALLIATIVE CARE
- Incorporation date
- 1987-11-13
- Incorporation state
- NY
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 39 BROADWAY 200
- City
- NEW YORK
- State
- NY
- Zip code
- 100063039