- Enrollment id
- O20161028000883
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1467477000
- Multiple npi flag
- N
- Ccn
- 451658
- Associate id
- 5193634111
- Organization name
- CHILDRESS COUNTY HOSPITAL DISTRICT
- Doing business as name
- CHILDRESS REGIONAL MEDICAL CENTER HOSPICE
- Incorporation state
- TX
- Organization type structure
- GOVERNMENT
- Proprietary nonprofit
- N
- Address line 1
- 901 US HWY 83 NORTH
- City
- CHILDRESS
- State
- TX
- Zip code
- 792011030