- Enrollment id
- O20220323001533
- Enrollment state
- FL
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1437813185
- Multiple npi flag
- N
- Ccn
- 105803
- Associate id
- 2961897228
- Organization name
- TH OPCO LLC
- Doing business as name
- THE TERRACE OF HIALEAH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- TERRACE OF HIALEAH, THE
- Affiliation entity name
- ELEVATE CARE
- Affiliation entity id
- 197
- Address line 1
- 190 W 28TH ST
- City
- HIALEAH
- State
- FL
- Zip code
- 330101606