- Enrollment id
- O20170614002218
- Enrollment state
- IL
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1891229324
- Multiple npi flag
- N
- Ccn
- 141697
- Associate id
- 7517235666
- Organization name
- UNITED HOSPICE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1420 RENAISSANCE DR
- Address line 2
- STE 209
- City
- PARK RIDGE
- State
- IL
- Zip code
- 600681342