- Enrollment id
- O20110815000664
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1285868448
- Multiple npi flag
- N
- Ccn
- 747747
- Associate id
- 2062681752
- Organization name
- CORDIAL CARE HOME HEALTH SERVICES INC.
- Incorporation date
- 2008-12-30
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 10935 ESTATE LN
- Address line 2
- STE 182
- City
- DALLAS
- State
- TX
- Zip code
- 752382469