- Enrollment id
- O20030612000067
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1467493429
- Multiple npi flag
- N
- Ccn
- 679191
- Associate id
- 6406766526
- Organization name
- GOOD SAMARITAN CAREGIVERS, LLC
- Doing business as name
- GOOD SAMARITAN HOME HEALTH AGENCY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 2500 TEXAS DR
- Address line 2
- STE 102
- City
- IRVING
- State
- TX
- Zip code
- 750627058
- Practice location type
- HHA BRANCH