- Enrollment id
- O20140407002064
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1366872095
- Multiple npi flag
- N
- Ccn
- 747201
- Associate id
- 1951533827
- Organization name
- NEW LIGHT HOME HEALTH INC
- Doing business as name
- LIVING HOPE HOME HEALTH-WEST
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 10707 CORPORATE DR
- Address line 2
- STE 153
- City
- STAFFORD
- State
- TX
- Zip code
- 774774092