- Enrollment id
- O20060809000104
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1407889579
- Multiple npi flag
- N
- Ccn
- 679601
- Associate id
- 4789687930
- Organization name
- LIFECARE HEALTH SERVICES, LLC.
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 9100 SOUTHWEST FWY
- Address line 2
- STE 160
- City
- HOUSTON
- State
- TX
- Zip code
- 770741584
- Practice location type
- HHA BRANCH