- Enrollment id
- O20181204000963
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1619457827
- Multiple npi flag
- N
- Ccn
- 677935
- Associate id
- 8820332711
- Organization name
- AN&SS CARE GROUP, LLC
- Doing business as name
- IVANA HOME HEALTH SERVICES
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 12808 W AIRPORT BLVD
- Address line 2
- STE 343
- City
- SUGAR LAND
- State
- TX
- Zip code
- 774786229