- Enrollment id
- O20130329000019
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1225374218
- Multiple npi flag
- N
- Ccn
- 671792
- Associate id
- 0941445613
- Organization name
- HARBOR HOSPICE MEDICAL CENTER - HOUSTON LP
- Incorporation date
- 2012-12-13
- Incorporation state
- TX
- Organization type structure
- OTHER
- Organization other type text
- LIMITED PARTNERSHIP
- Proprietary nonprofit
- P
- Address line 1
- 11980 KIRBY DR
- Address line 2
- STE 240
- City
- HOUSTON
- State
- TX
- Zip code
- 770454860