- Enrollment id
- O20170601001831
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1124561055
- Multiple npi flag
- N
- Ccn
- 741732
- Associate id
- 2264709807
- Organization name
- PREMIER HOSPICE LLC
- Doing business as name
- PREMIER HOSPICE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 4606 FM 1960 RD W
- Address line 2
- STE 675
- City
- HOUSTON
- State
- TX
- Zip code
- 770694629