- Enrollment id
- O20100714000400
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1093945701
- Multiple npi flag
- N
- Ccn
- 747530
- Associate id
- 9830221639
- Organization name
- BETHEL AMERICA HEALTH CARE LLC
- Incorporation date
- 2009-07-20
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 11104 W. AIRPORT BLVD.
- Address line 2
- SUITE 107
- City
- STAFFORD
- State
- TX
- Zip code
- 77477