- Enrollment id
- O20150904002201
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1174909758
- Multiple npi flag
- N
- Ccn
- 741633
- Associate id
- 2466768429
- Organization name
- ASERENE HEALTHCARE SERVICES,LLC
- Incorporation date
- 2014-07-23
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 10701 CORPORATE DR
- Address line 2
- STE 391A
- City
- STAFFORD
- State
- TX
- Zip code
- 774774036