- Enrollment id
- O20041012000066
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1396851267
- Multiple npi flag
- N
- Ccn
- 677803
- Associate id
- 3173514791
- Organization name
- EMBASSY HEALTHCARE SYSTEM INC
- Doing business as name
- EMBASSY HOME HEALTHCARE
- Incorporation date
- 2002-05-17
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 10701 CORPORATE DRIVE
- Address line 2
- SUITE 395
- City
- STAFFORD
- State
- TX
- Zip code
- 774774093