- Enrollment id
- O20110624000208
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1992017487
- Multiple npi flag
- N
- Ccn
- 747620
- Associate id
- 8426236365
- Organization name
- NOAH'S ARK HOME HEALTHCARE,INC
- Incorporation date
- 2010-07-13
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1201 N WATSON ROAD
- Address line 2
- STE 297A
- City
- ARLINGTON
- State
- TX
- Zip code
- 760066221