- Enrollment id
- O20220920003701
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1881979904
- Multiple npi flag
- N
- Ccn
- 748100
- Associate id
- 8527296797
- Organization name
- CARISSA HEALTH CARE SERVICES INC
- Incorporation date
- 2011-07-27
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 10701 CORPORATE DR
- Address line 2
- STE 340-113
- City
- STAFFORD
- State
- TX
- Zip code
- 774774096