- Enrollment id
- O20060831000464
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1396760054
- Multiple npi flag
- N
- Ccn
- 679652
- Associate id
- 4486658549
- Organization name
- IMPARTING KNOWLEDGE HOME HEALTH LLC
- Doing business as name
- LUCENT HEALTH GROUP
- Incorporation date
- 2006-05-03
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 1255 W 15TH ST
- Address line 2
- STE 900
- City
- PLANO
- State
- TX
- Zip code
- 750754214