- Enrollment id
- O20100713000409
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1235373267
- Multiple npi flag
- N
- Ccn
- 747467
- Associate id
- 1153453097
- Organization name
- FOUR SEASONS HOME HEALTH SERVICES INC.
- Doing business as name
- FOUR SEASONS HOME HEALTH SERVICES, INC
- Incorporation date
- 2008-12-01
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 9304 FOREST LANE
- Address line 2
- SUITRE S201
- City
- DALLAS
- State
- TX
- Zip code
- 75243