- Enrollment id
- O20131024001051
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1851638753
- Multiple npi flag
- N
- Ccn
- 747942
- Associate id
- 1658506886
- Organization name
- UNA BENDICION HOME HEALTH LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 1736 RIVERSIDE STREET
- City
- RIO GRANDE CITY
- State
- TX
- Zip code
- 785825726