- Enrollment id
- O20071023000150
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1083701288
- Multiple npi flag
- N
- Ccn
- 747147
- Associate id
- 2860588860
- Organization name
- C C C HEALTH CARE INC
- Incorporation date
- 2006-11-08
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12808 W AIRPORT BLVD
- Address line 2
- STE 306
- City
- SUGAR LAND
- State
- TX
- Zip code
- 774786222