- Enrollment id
- O20140625001776
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1063756880
- Multiple npi flag
- N
- Ccn
- 747951
- Associate id
- 4486879905
- Organization name
- LE CELESTE HOMECARE INC
- Incorporation date
- 2012-11-15
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1919 S SHILOH RD
- Address line 2
- STE 650
- City
- GARLAND
- State
- TX
- Zip code
- 750428217