- Enrollment id
- O20131202000001
- Enrollment state
- ID
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1821427741
- Multiple npi flag
- N
- Ccn
- 131571
- Associate id
- 2365678075
- Organization name
- ACHS HOSPICE & PALLIATIVE CARE, LLC
- Doing business as name
- ALL CARE HOSPICE & PALLIATIVE CARE
- Incorporation date
- 2013-09-30
- Incorporation state
- ID
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 815 S BRIDGEWAY PL
- Address line 2
- STE 122
- City
- EAGLE
- State
- ID
- Zip code
- 836166022