- Enrollment id
- O20190510000572
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1720569114
- Multiple npi flag
- N
- Ccn
- 678464
- Associate id
- 9931443553
- Organization name
- REGENCY IHS HOME CARE SERVICES LLC
- Doing business as name
- ATEX HOME HEALTHCARE
- Incorporation date
- 2018-09-14
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 4444 CORONA DR
- Address line 2
- STE 100
- City
- CORPUS CHRISTI
- State
- TX
- Zip code
- 784114321