- Enrollment id
- O20210528001927
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1023643061
- Multiple npi flag
- N
- Ccn
- A91517
- Associate id
- 1759780422
- Organization name
- VENARKS HOSPICE INC
- Incorporation date
- 2020-03-06
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 777 S CENTRAL EXPY
- Address line 2
- STE 5F
- City
- RICHARDSON
- State
- TX
- Zip code
- 750807420