- Enrollment id
- O20050622000693
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1255379178
- Multiple npi flag
- N
- Ccn
- 677847
- Associate id
- 8628013406
- Organization name
- EXCEL PLUS HOME HEALTH LLC
- Incorporation date
- 2001-09-04
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 1701 N COLLINS BLVD
- Address line 2
- STE 3000A
- City
- RICHARDSON
- State
- TX
- Zip code
- 750803564