- Enrollment id
- O20091123000083
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1467603712
- Multiple npi flag
- N
- Ccn
- 747546
- Associate id
- 8729127220
- Organization name
- STARCREST HEALTHCARE SERVICES, INC
- Doing business as name
- STARECREST HEALTHCARE SERVICES
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 8111 LBJ FWY
- Address line 2
- STE 1225A
- City
- DALLAS
- State
- TX
- Zip code
- 752511313