- Enrollment id
- O20031229000761
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1982695862
- Multiple npi flag
- N
- Ccn
- 679478
- Associate id
- 5193623171
- Organization name
- GOOD SAMARITAN HOME HEALTH CARE INC.
- Incorporation date
- 2003-09-19
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 9550 SKILLMAN ST
- Address line 2
- STE 320
- City
- DALLAS
- State
- TX
- Zip code
- 752438252