- Enrollment id
- O20080303000047
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1679691844
- Multiple npi flag
- N
- Ccn
- 747136
- Associate id
- 0840374716
- Organization name
- LIFE HOME HEALTH CARE, INC.
- Incorporation date
- 2007-03-13
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1609 DAVENPORT ST
- Address line 2
- SUITE B
- City
- WESLACO
- State
- TX
- Zip code
- 785966543