- Enrollment id
- O20120308000292
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1629000351
- Multiple npi flag
- N
- Ccn
- 457489
- Associate id
- 5193634111
- Organization name
- CHILDRESS COUNTY HOSPITAL DISTRICT
- Doing business as name
- CHILDRESS REGIONAL MEDICAL CENTER HOME HEALTH
- Organization type structure
- OTHER
- Organization other type text
- HOSPITAL DISTRICT
- Proprietary nonprofit
- N
- Address line 1
- 901 US HIGHWAY 83 N
- City
- CHILDRESS
- State
- TX
- Zip code
- 792012320