- Enrollment id
- O20190617000481
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1215421706
- Multiple npi flag
- N
- Ccn
- 971609
- Associate id
- 8628301108
- Organization name
- A & B HOSPICE SERVICES LLC
- Doing business as name
- TRINITY HOSPICE
- Incorporation date
- 2016-08-18
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 350 PINE ST
- Address line 2
- STE 711
- City
- BEAUMONT
- State
- TX
- Zip code
- 777012401