- Enrollment id
- O20100125000564
- Enrollment state
- WI
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1992891758
- Multiple npi flag
- N
- Ccn
- 521508
- Associate id
- 9537201801
- Organization name
- HOMECARE HEALTH SERVICES INC
- Doing business as name
- MANITOWOC COUNTY COMMUNITY HOSPICE
- Incorporation date
- 1975-05-27
- Incorporation state
- WI
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1004 WASHINGTON STREET
- City
- MANITOWOC
- State
- WI
- Zip code
- 542205207