- Enrollment id
- O20080122000337
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1730296849
- Multiple npi flag
- N
- Ccn
- 459373
- Associate id
- 6709967391
- Organization name
- SURE HOME HEALTH SERVICES LLC
- Incorporation date
- 1997-10-23
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 12115 SELF PLAZA DR
- City
- DALLAS
- State
- TX
- Zip code
- 752181469