- Enrollment id
- O20211111000762
- Enrollment state
- DE
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1265013908
- Multiple npi flag
- N
- Ccn
- 085013
- Associate id
- 8224427349
- Organization name
- COMPLETE CARE AT HILLSIDE LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- COMPLETE CARE AT HILLSIDE LLC
- Affiliation entity name
- COMPLETE CARE
- Affiliation entity id
- 157
- Address line 1
- 810 S BROOM ST
- City
- WILMINGTON
- State
- DE
- Zip code
- 198054245