- Enrollment id
- O20070917000017
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1114088572
- Multiple npi flag
- N
- Ccn
- 747367
- Associate id
- 5698869089
- Organization name
- LAURENT HOME HEALTH AGENCY INC.
- Doing business as name
- LAURENT HOME HEALTH
- Incorporation date
- 2006-06-14
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1201 N WATSON RD
- Address line 2
- SUITE 292
- City
- ARLINGTON
- State
- TX
- Zip code
- 760066190
- Practice location type
- HHA BRANCH