- Enrollment id
- O20120719000613
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1962781443
- Multiple npi flag
- N
- Ccn
- 673162
- Associate id
- 2062678022
- Organization name
- CANTEX HOME HEALTH HOUSTON LLC
- Doing business as name
- THERACARE HOME HEALTH
- Incorporation date
- 2011-08-10
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 11104 W AIRPORT BLVD
- Address line 2
- STE 255-A
- City
- STAFFORD
- State
- TX
- Zip code
- 774773035