- Enrollment id
- O20240618000945
- Enrollment state
- NV
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1881452837
- Multiple npi flag
- N
- Ccn
- 291730
- Associate id
- 3779026893
- Organization name
- ETERNITY CARE SERVICES INC.
- Doing business as name
- ETERNITY CARE HOSPICE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 2675 S JONES BLVD
- Address line 2
- STE 104
- City
- LAS VEGAS
- State
- NV
- Zip code
- 891465607