- Enrollment id
- O20160902001958
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1154790871
- Multiple npi flag
- N
- Ccn
- 679651
- Associate id
- 0042506867
- Organization name
- CARELIFE HEALTH SERVICES INC
- Doing business as name
- AMAZING HEALTH SERVICES
- Incorporation date
- 2015-07-10
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1908 ROYAL LN
- Address line 2
- STE 750
- City
- DALLAS
- State
- TX
- Zip code
- 752293128