- Enrollment id
- O20111019000342
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1396037693
- Multiple npi flag
- N
- Ccn
- 671711
- Associate id
- 5890967764
- Organization name
- HARBOR HOSPICE OF CENTRAL HOUSTON LP
- Incorporation date
- 2011-04-27
- Incorporation state
- TX
- Organization type structure
- PARTNERSHIP
- Proprietary nonprofit
- P
- Address line 1
- 11980 KIRBY DR
- Address line 2
- STE 220
- City
- HOUSTON
- State
- TX
- Zip code
- 770454860