- Enrollment id
- O20200504002565
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1316262017
- Multiple npi flag
- N
- Ccn
- 748056
- Associate id
- 5193156362
- Organization name
- DIAMOND HEART HEALTHCARE, INC.
- Incorporation date
- 2009-08-03
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1201 N WATSON RD
- Address line 2
- STE 169
- City
- ARLINGTON
- State
- TX
- Zip code
- 760066292
- Practice location type
- HHA BRANCH