- Enrollment id
- O20230914003861
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1891493722
- Multiple npi flag
- N
- Ccn
- 748122
- Associate id
- 4082078662
- Organization name
- ANGEL WINGS HOME HEALTH SERVICES LLC
- Incorporation date
- 2023-01-30
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 1201 N WATSON RD
- Address line 2
- STE 187
- City
- ARLINGTON
- State
- TX
- Zip code
- 760066225
- Practice location type
- HHA BRANCH