- Enrollment id
- O20190326001398
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1346720075
- Multiple npi flag
- N
- Ccn
- 971620
- Associate id
- 9032459219
- Organization name
- SHELTER HOSPICE INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 8111 LBJ FWY
- Address line 2
- STE 1330
- City
- DALLAS
- State
- TX
- Zip code
- 752511475