- Enrollment id
- O20241004000164
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1326806522
- Multiple npi flag
- N
- Ccn
- E21511
- Associate id
- 3072044890
- Organization name
- RENOWN HOSPICE CARE LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 3235 N MESQUITE DR
- Address line 2
- STE 700
- City
- MESQUITE
- State
- TX
- Zip code
- 751504044