- Enrollment id
- O20180703001757
- Enrollment state
- IN
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1861989998
- Multiple npi flag
- N
- Ccn
- 151629
- Associate id
- 8921354044
- Organization name
- COMFORT 1 HOSPICE LLC
- Incorporation date
- 2017-06-23
- Incorporation state
- IN
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 129 S DIXIE WAY
- Address line 2
- STE B
- City
- SOUTH BEND
- State
- IN
- Zip code
- 466373392