- Enrollment id
- O20070125000072
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1821011230
- Multiple npi flag
- N
- Ccn
- 673194
- Associate id
- 5597766113
- Organization name
- MHS-MISSIONCARE HEALTH SERVICES, INC.
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 3939 US HIGHWAY 80 E
- Address line 2
- STE 470B
- City
- MESQUITE
- State
- TX
- Zip code
- 751503373