- Enrollment id
- O20080723000021
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1164698965
- Multiple npi flag
- N
- Ccn
- 679705
- Associate id
- 6002989175
- Organization name
- GOOD HOPE HEALTHCARE SERVICES LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 3202 DELAFORD DRIVE
- City
- CARROLLTON
- State
- TX
- Zip code
- 750073036