- Enrollment id
- O20160525000979
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1245601442
- Multiple npi flag
- N
- Ccn
- 741641
- Associate id
- 5496044836
- Organization name
- ANGEL WINGS HEALTHCARE LLC
- Doing business as name
- ANGEL WINGS HOSPICE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 1201 N WATSON RD
- Address line 2
- STE 187
- City
- ARLINGTON
- State
- TX
- Zip code
- 760066225