- Enrollment id
- O20260224002262
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1003792201
- Multiple npi flag
- N
- Ccn
- E21528
- Associate id
- 9537640917
- Organization name
- SOUTH TEXAS HOSPICE LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 4100 E PIEDRAS DR
- Address line 2
- STE 268
- City
- SAN ANTONIO
- State
- TX
- Zip code
- 782281426