- Enrollment id
- O20220516002378
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1609442706
- Multiple npi flag
- N
- Ccn
- 748084
- Associate id
- 4082091921
- Organization name
- LS HEALTHCARE SERVICES LLC
- Incorporation date
- 2020-07-29
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 8500 N STEMMONS FWY
- Address line 2
- # 2087
- City
- DALLAS
- State
- TX
- Zip code
- 752473832
- Practice location type
- HHA BRANCH