- Enrollment id
- O20120426000498
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1154403251
- Multiple npi flag
- N
- Ccn
- 459468
- Associate id
- 5698937282
- Organization name
- ROCK OF AGES HOME HEALTH CARE INC
- Incorporation date
- 1997-07-15
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 2245 VALWOOD PKWY
- Address line 2
- STE 104
- City
- FARMERS BRANCH
- State
- TX
- Zip code
- 752343407