- Enrollment id
- O20030909000002
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1467410415
- Multiple npi flag
- N
- Ccn
- 679357
- Associate id
- 9638080948
- Organization name
- CARTER HEALTHCARE OF DEL RIO, LLC
- Doing business as name
- CARTER HEALTHCARE
- Incorporation date
- 2003-10-02
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 3201 CHERRY RIDGE DR
- Address line 2
- STE 211C
- City
- SAN ANTONIO
- State
- TX
- Zip code
- 782304835