- Enrollment id
- O20190927002154
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1497231724
- Multiple npi flag
- N
- Ccn
- 748029
- Associate id
- 7719217124
- Organization name
- AXON HOME HEALTH SERVICES CORP
- Doing business as name
- AXON HOME HEALTH
- Incorporation date
- 2013-03-26
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1526 KATY GAP RD
- Address line 2
- STE 902
- City
- KATY
- State
- TX
- Zip code
- 774946548