- Enrollment id
- O20220331001343
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1780356931
- Multiple npi flag
- N
- Ccn
- A91591
- Associate id
- 4789070749
- Organization name
- ANCHORED BY GRACE HOSPICE CARE INC.
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 2819 NW LOOP 410
- Address line 2
- STE P
- City
- SAN ANTONIO
- State
- TX
- Zip code
- 782305105