- Enrollment id
- O20240628001386
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1528757242
- Multiple npi flag
- N
- Ccn
- A91754
- Associate id
- 6103360300
- Organization name
- AMAYA HOSPICE LLC
- Incorporation date
- 2023-05-02
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 8500 N STEMMONS FWY
- Address line 2
- STE 5054
- City
- DALLAS
- State
- TX
- Zip code
- 752473955