- Enrollment id
- O20250226003368
- Enrollment state
- TX
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1629806740
- Multiple npi flag
- N
- Ccn
- E21504
- Associate id
- 7113447624
- Organization name
- PROTEAM HOSPICE LLC
- Incorporation date
- 2024-07-18
- Incorporation state
- TX
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 10935 ESTATE LN
- Address line 2
- STE 190
- City
- DALLAS
- State
- TX
- Zip code
- 752382371