- Enrollment id
- O20060206000817
- Enrollment state
- MT
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1942312087
- Multiple npi flag
- N
- Ccn
- 271524
- Associate id
- 4183691132
- Organization name
- PLAINS HOSPITAL CORPORATION
- Doing business as name
- CLARK FORK VALLEY HOSPICE
- Incorporation date
- 2002-01-01
- Incorporation state
- MT
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 10 KRUGER RD
- City
- PLAINS
- State
- MT
- Zip code
- 598599271