- Enrollment id
- O20190923003243
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1982160495
- Multiple npi flag
- N
- Ccn
- 747984
- Associate id
- 3870823578
- Organization name
- JUBILEE CARE @ HOME HEALTH CARE SERVICES LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 300 JACKSON ST
- City
- RICHMOND
- State
- TX
- Zip code
- 774693109
- Practice location type
- HHA BRANCH