- Enrollment id
- O20160121000455
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1124405253
- Multiple npi flag
- N
- Ccn
- 741683
- Associate id
- 9830492180
- Organization name
- EDEN HOSPICE CARE SERVICES, INC.
- Doing business as name
- EDEN HOSPICE
- Incorporation date
- 2015-04-21
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 2440 TEXAS PKWY
- Address line 2
- STE 260
- City
- MISSOURI CITY
- State
- TX
- Zip code
- 774894085