- Enrollment id
- O20100618000557
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1598702946
- Multiple npi flag
- N
- Ccn
- 453112
- Associate id
- 2466582382
- Organization name
- DOVE HOME CARE LLC
- Incorporation date
- 2003-12-18
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 4105 W SPRING CREEK PKWY
- Address line 2
- STE 612
- City
- PLANO
- State
- TX
- Zip code
- 750245283