- Enrollment id
- O20220912002696
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1417614314
- Multiple npi flag
- N
- Ccn
- A91549
- Associate id
- 9133504152
- Organization name
- SUNCREST HOSPICE CARE LLC
- Incorporation date
- 2021-11-26
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 2646 S LOOP W
- Address line 2
- STE 635B
- City
- HOUSTON
- State
- TX
- Zip code
- 770542665